National Provider Identifier [NPI]: |
1134236789 |
Last Name Of The Provider |
ALOMAN |
First Name Of The Provider |
MONICA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
757 45TH AVE |
Street Address 2 Of The Provider |
STE. 201 |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212911 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1904 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
187895.9 |
Total Medicare Allowed Amount |
94137.87 |
Total Medicare Payment Amount |
69659.94 |
Total Medicare Standardized Payment Amount |
74320.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1058 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
28431.9 |
Total Drug Medicare AllowedAmount |
11201.54 |
Total Drug Medicare PaymentAmount |
8738.99 |
Total Drug Medicare Standardized Payment Amount |
8738.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
846 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
159464 |
Total Medical Medicare Allowed Amount |
82936.33 |
Total Medical Medicare Payment Amount |
60920.95 |
Total Medical Medicare Standardized Payment Amount |
65581.19 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
74 |
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 |
229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3164 |