National Provider Identifier [NPI]: |
1538124946 |
Last Name Of The Provider |
LEYKO |
First Name Of The Provider |
BARTLOMIEJ |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 W CLARENDON AVE |
Street Address 2 Of The Provider |
STE 120 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850133421 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
23628 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
341089.5 |
Total Medicare Allowed Amount |
245609.76 |
Total Medicare Payment Amount |
184452.22 |
Total Medicare Standardized Payment Amount |
183598.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
248 |
Number Of Medicare Beneficiaries With Drug Services |
110 |
Total Drug Submitted ChargeAmount |
2299 |
Total Drug Medicare AllowedAmount |
1807.43 |
Total Drug Medicare PaymentAmount |
1682.72 |
Total Drug Medicare Standardized Payment Amount |
1682.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
23380 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
338790.5 |
Total Medical Medicare Allowed Amount |
243802.33 |
Total Medical Medicare Payment Amount |
182769.5 |
Total Medical Medicare Standardized Payment Amount |
181916.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
239 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
369 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
28 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8718 |