National Provider Identifier [NPI]: |
1093978686 |
Last Name Of The Provider |
SCHULZ |
First Name Of The Provider |
JAMIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
525 ALEXANDRIA PIKE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
SOUTHGATE |
Zip Code Of The Provider |
410713290 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1252 |
Number Of Medicare Beneficiaries |
402 |
Total Submitted Charge Amount |
174113 |
Total Medicare Allowed Amount |
104598.43 |
Total Medicare Payment Amount |
77599.68 |
Total Medicare Standardized Payment Amount |
82216.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
246 |
Total Drug Medicare AllowedAmount |
142.99 |
Total Drug Medicare PaymentAmount |
120.15 |
Total Drug Medicare Standardized Payment Amount |
120.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1241 |
Number Of Medicare Beneficiaries With Medical Services |
402 |
Total Medical Submitted Charge Amount |
173867 |
Total Medical Medicare Allowed Amount |
104455.44 |
Total Medical Medicare Payment Amount |
77479.53 |
Total Medical Medicare Standardized Payment Amount |
82096.31 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
387 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
264 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8142 |