National Provider Identifier [NPI]: |
1659362200 |
Last Name Of The Provider |
ACKER |
First Name Of The Provider |
HERBERT |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3534 BROOKLYN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468091361 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2091 |
Number Of Medicare Beneficiaries |
448 |
Total Submitted Charge Amount |
247877 |
Total Medicare Allowed Amount |
121144.5 |
Total Medicare Payment Amount |
87725.48 |
Total Medicare Standardized Payment Amount |
90737.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
297 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
7360 |
Total Drug Medicare AllowedAmount |
2616.35 |
Total Drug Medicare PaymentAmount |
2247.13 |
Total Drug Medicare Standardized Payment Amount |
2247.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1794 |
Number Of Medicare Beneficiaries With Medical Services |
448 |
Total Medical Submitted Charge Amount |
240517 |
Total Medical Medicare Allowed Amount |
118528.15 |
Total Medical Medicare Payment Amount |
85478.35 |
Total Medical Medicare Standardized Payment Amount |
88490.16 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
298 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
427 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
416 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.936 |