National Provider Identifier [NPI]: |
1063453611 |
Last Name Of The Provider |
STECYK |
First Name Of The Provider |
OREST |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 E ROYALTON RD # 101 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROADVIEW HTS |
Zip Code Of The Provider |
441472591 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1103 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
173470 |
Total Medicare Allowed Amount |
118438.18 |
Total Medicare Payment Amount |
88513.33 |
Total Medicare Standardized Payment Amount |
90891.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
1856 |
Total Drug Medicare AllowedAmount |
388.81 |
Total Drug Medicare PaymentAmount |
365.9 |
Total Drug Medicare Standardized Payment Amount |
365.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1053 |
Number Of Medicare Beneficiaries With Medical Services |
303 |
Total Medical Submitted Charge Amount |
171614 |
Total Medical Medicare Allowed Amount |
118049.37 |
Total Medical Medicare Payment Amount |
88147.43 |
Total Medical Medicare Standardized Payment Amount |
90525.21 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
287 |
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6915 |