National Provider Identifier [NPI]: |
1356331698 |
Last Name Of The Provider |
VOLLENWEIDER |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1222 S ORANGE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
328061215 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
1370 |
Number Of Medicare Beneficiaries |
378 |
Total Submitted Charge Amount |
615209.66 |
Total Medicare Allowed Amount |
149631.22 |
Total Medicare Payment Amount |
115305.78 |
Total Medicare Standardized Payment Amount |
114951.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
99 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
159.66 |
Total Drug Medicare AllowedAmount |
50.23 |
Total Drug Medicare PaymentAmount |
42.3 |
Total Drug Medicare Standardized Payment Amount |
42.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
1271 |
Number Of Medicare Beneficiaries With Medical Services |
378 |
Total Medical Submitted Charge Amount |
615050 |
Total Medical Medicare Allowed Amount |
149580.99 |
Total Medical Medicare Payment Amount |
115263.48 |
Total Medical Medicare Standardized Payment Amount |
114909.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
275 |
Number Of Black or African American Beneficiaries |
60 |
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 |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
58 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
3.0054 |