National Provider Identifier [NPI]: |
1457325268 |
Last Name Of The Provider |
OFENLOCH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
455 PINELLAS ST |
Street Address 2 Of The Provider |
SUITE 320 |
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
337563369 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
674 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
777621 |
Total Medicare Allowed Amount |
325168.4 |
Total Medicare Payment Amount |
254661.09 |
Total Medicare Standardized Payment Amount |
243908.54 |
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 |
88 |
Number Of Medical Services |
674 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
777621 |
Total Medical Medicare Allowed Amount |
325168.4 |
Total Medical Medicare Payment Amount |
254661.09 |
Total Medical Medicare Standardized Payment Amount |
243908.54 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
274 |
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 |
260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
48 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1239 |