National Provider Identifier [NPI]: |
1033290440 |
Last Name Of The Provider |
BASHALL |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5330 E STOP 11 RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462376345 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2812 |
Number Of Medicare Beneficiaries |
1299 |
Total Submitted Charge Amount |
424157 |
Total Medicare Allowed Amount |
183977.88 |
Total Medicare Payment Amount |
136917.75 |
Total Medicare Standardized Payment Amount |
143792.24 |
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 |
39 |
Number Of Medical Services |
2812 |
Number Of Medicare Beneficiaries With Medical Services |
1299 |
Total Medical Submitted Charge Amount |
424157 |
Total Medical Medicare Allowed Amount |
183977.88 |
Total Medical Medicare Payment Amount |
136917.75 |
Total Medical Medicare Standardized Payment Amount |
143792.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
513 |
Number Of Beneficiaries Age 75 to 84 |
408 |
Number Of Beneficiaries Age Greater 84 |
214 |
Number Of Female Beneficiaries |
690 |
Number Of Male Beneficiaries |
609 |
Number Of Non Hispanic White Beneficiaries |
1250 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
1054 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
245 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5837 |