National Provider Identifier [NPI]: |
1376757377 |
Last Name Of The Provider |
SPRUNGER |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8202 CLEARVISTA PKWY |
Street Address 2 Of The Provider |
SUITE 6B |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462561442 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
526 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
54567 |
Total Medicare Allowed Amount |
38570.04 |
Total Medicare Payment Amount |
26137.83 |
Total Medicare Standardized Payment Amount |
28115.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
2566 |
Total Drug Medicare AllowedAmount |
1737.6 |
Total Drug Medicare PaymentAmount |
1700.76 |
Total Drug Medicare Standardized Payment Amount |
1700.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
474 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
52001 |
Total Medical Medicare Allowed Amount |
36832.44 |
Total Medical Medicare Payment Amount |
24437.07 |
Total Medical Medicare Standardized Payment Amount |
26415.05 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
134 |
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 |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0112 |