National Provider Identifier [NPI]: |
1588668347 |
Last Name Of The Provider |
PERE |
First Name Of The Provider |
JAVIER |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
770 W HIGH ST |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
LIMA |
Zip Code Of The Provider |
458013990 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1932 |
Number Of Medicare Beneficiaries |
646 |
Total Submitted Charge Amount |
302780 |
Total Medicare Allowed Amount |
202769.18 |
Total Medicare Payment Amount |
155586.86 |
Total Medicare Standardized Payment Amount |
159469.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
1932 |
Number Of Medicare Beneficiaries With Medical Services |
646 |
Total Medical Submitted Charge Amount |
302780 |
Total Medical Medicare Allowed Amount |
202769.18 |
Total Medical Medicare Payment Amount |
155586.86 |
Total Medical Medicare Standardized Payment Amount |
159469.22 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
130 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
323 |
Number Of Male Beneficiaries |
323 |
Number Of Non Hispanic White Beneficiaries |
580 |
Number Of Black or African American Beneficiaries |
43 |
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 |
512 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8213 |