National Provider Identifier [NPI]: |
1194759456 |
Last Name Of The Provider |
MORRISON |
First Name Of The Provider |
APRIL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7916 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044140 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
659 |
Number Of Medicare Beneficiaries |
283 |
Total Submitted Charge Amount |
104718 |
Total Medicare Allowed Amount |
57918.17 |
Total Medicare Payment Amount |
44187.35 |
Total Medicare Standardized Payment Amount |
46649.58 |
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 |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
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 |
67 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
24 |
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 |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
3.2102 |