National Provider Identifier [NPI]: |
1760441968 |
Last Name Of The Provider |
KETCHEL |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2625 N CRAYCROFT RD |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857122254 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
37625 |
Number Of Medicare Beneficiaries |
348 |
Total Submitted Charge Amount |
2294595 |
Total Medicare Allowed Amount |
663869.28 |
Total Medicare Payment Amount |
512663.7 |
Total Medicare Standardized Payment Amount |
512213.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
58 |
Number Of Drug Services |
36191 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
2000177 |
Total Drug Medicare AllowedAmount |
570069.73 |
Total Drug Medicare PaymentAmount |
445189.55 |
Total Drug Medicare Standardized Payment Amount |
445189.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1434 |
Number Of Medicare Beneficiaries With Medical Services |
348 |
Total Medical Submitted Charge Amount |
294418 |
Total Medical Medicare Allowed Amount |
93799.55 |
Total Medical Medicare Payment Amount |
67474.15 |
Total Medical Medicare Standardized Payment Amount |
67024.26 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
298 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
52 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8395 |