National Provider Identifier [NPI]: |
1093862815 |
Last Name Of The Provider |
BECK |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 N 1900 E |
Street Address 2 Of The Provider |
3C444 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841320002 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
191 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
315618.88 |
Total Medicare Allowed Amount |
63741.35 |
Total Medicare Payment Amount |
49315.68 |
Total Medicare Standardized Payment Amount |
50264.41 |
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 |
66 |
Number Of Medical Services |
191 |
Number Of Medicare Beneficiaries With Medical Services |
170 |
Total Medical Submitted Charge Amount |
315618.88 |
Total Medical Medicare Allowed Amount |
63741.35 |
Total Medical Medicare Payment Amount |
49315.68 |
Total Medical Medicare Standardized Payment Amount |
50264.41 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
147 |
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 |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5377 |