National Provider Identifier [NPI]: |
1750456687 |
Last Name Of The Provider |
REDKO |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 PROFESSIONAL DRIVE |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
PETALUMA |
Zip Code Of The Provider |
949545110 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
118 |
Number Of Services |
5225 |
Number Of Medicare Beneficiaries |
405 |
Total Submitted Charge Amount |
1073112 |
Total Medicare Allowed Amount |
364539.6 |
Total Medicare Payment Amount |
273505.67 |
Total Medicare Standardized Payment Amount |
262241.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
243 |
Number Of Medicare Beneficiaries With Drug Services |
60 |
Total Drug Submitted ChargeAmount |
11810 |
Total Drug Medicare AllowedAmount |
4617.16 |
Total Drug Medicare PaymentAmount |
3603.42 |
Total Drug Medicare Standardized Payment Amount |
3603.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
116 |
Number Of Medical Services |
4982 |
Number Of Medicare Beneficiaries With Medical Services |
405 |
Total Medical Submitted Charge Amount |
1061302 |
Total Medical Medicare Allowed Amount |
359922.44 |
Total Medical Medicare Payment Amount |
269902.25 |
Total Medical Medicare Standardized Payment Amount |
258638.41 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
343 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2696 |