National Provider Identifier [NPI]: |
1326122136 |
Last Name Of The Provider |
HENDRICK |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
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Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
711 TROY SCHENECTADY RD |
Street Address 2 Of The Provider |
SUITE 114 |
City Of The Provider |
LATHAM |
Zip Code Of The Provider |
121102442 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
137 |
Number Of Services |
5428 |
Number Of Medicare Beneficiaries |
3169 |
Total Submitted Charge Amount |
298446.55 |
Total Medicare Allowed Amount |
112229.66 |
Total Medicare Payment Amount |
88575.47 |
Total Medicare Standardized Payment Amount |
92663.26 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
721 |
Number Of Beneficiaries Age 65 to 74 |
1048 |
Number Of Beneficiaries Age 75 to 84 |
821 |
Number Of Beneficiaries Age Greater 84 |
579 |
Number Of Female Beneficiaries |
1885 |
Number Of Male Beneficiaries |
1284 |
Number Of Non Hispanic White Beneficiaries |
2861 |
Number Of Black or African American Beneficiaries |
185 |
Number Of AsianPacific Islander Beneficiaries |
27 |
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
2048 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1121 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7572 |