National Provider Identifier [NPI]: |
1922036490 |
Last Name Of The Provider |
HOGENKAMP |
First Name Of The Provider |
PETER |
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 |
10 COMMONS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RUTLAND |
Zip Code Of The Provider |
057014651 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
2326 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
204253.69 |
Total Medicare Allowed Amount |
141686.92 |
Total Medicare Payment Amount |
112698.6 |
Total Medicare Standardized Payment Amount |
113690.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
293 |
Number Of Medicare Beneficiaries With Drug Services |
267 |
Total Drug Submitted ChargeAmount |
8640.19 |
Total Drug Medicare AllowedAmount |
4683.13 |
Total Drug Medicare PaymentAmount |
4555.17 |
Total Drug Medicare Standardized Payment Amount |
4555.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2033 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
195613.5 |
Total Medical Medicare Allowed Amount |
137003.79 |
Total Medical Medicare Payment Amount |
108143.43 |
Total Medical Medicare Standardized Payment Amount |
109135.32 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
254 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
437 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9798 |