National Provider Identifier [NPI]: |
1326146994 |
Last Name Of The Provider |
BLUME |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 NE RANDOLPH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616061919 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
764 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
176631 |
Total Medicare Allowed Amount |
74405.75 |
Total Medicare Payment Amount |
53301.28 |
Total Medicare Standardized Payment Amount |
54832.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
764 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
176631 |
Total Medical Medicare Allowed Amount |
74405.75 |
Total Medical Medicare Payment Amount |
53301.28 |
Total Medical Medicare Standardized Payment Amount |
54832.9 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
373 |
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 |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.4129 |