National Provider Identifier [NPI]: |
1891799391 |
Last Name Of The Provider |
ZON |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
615 N MICHIGAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466011033 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
135 |
Number Of Services |
112558 |
Number Of Medicare Beneficiaries |
586 |
Total Submitted Charge Amount |
4532447 |
Total Medicare Allowed Amount |
1783104.85 |
Total Medicare Payment Amount |
1385406.8 |
Total Medicare Standardized Payment Amount |
1393324.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
77 |
Number Of Drug Services |
109381 |
Number Of Medicare Beneficiaries With Drug Services |
288 |
Total Drug Submitted ChargeAmount |
3673758 |
Total Drug Medicare AllowedAmount |
1508034.11 |
Total Drug Medicare PaymentAmount |
1176054.77 |
Total Drug Medicare Standardized Payment Amount |
1176054.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
3177 |
Number Of Medicare Beneficiaries With Medical Services |
585 |
Total Medical Submitted Charge Amount |
858689 |
Total Medical Medicare Allowed Amount |
275070.74 |
Total Medical Medicare Payment Amount |
209352.03 |
Total Medical Medicare Standardized Payment Amount |
217269.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
414 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
530 |
Number Of Black or African American Beneficiaries |
44 |
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 |
512 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
63 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.811 |