National Provider Identifier [NPI]: |
1881786762 |
Last Name Of The Provider |
LIRONES |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9895 RAPID CITY RD NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
RAPID CITY |
Zip Code Of The Provider |
496769506 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
2125 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
109625 |
Total Medicare Allowed Amount |
83858.35 |
Total Medicare Payment Amount |
60955.33 |
Total Medicare Standardized Payment Amount |
63593.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
448 |
Number Of Medicare Beneficiaries With Drug Services |
132 |
Total Drug Submitted ChargeAmount |
7290 |
Total Drug Medicare AllowedAmount |
4485.47 |
Total Drug Medicare PaymentAmount |
3573.47 |
Total Drug Medicare Standardized Payment Amount |
3573.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
1677 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
102335 |
Total Medical Medicare Allowed Amount |
79372.88 |
Total Medical Medicare Payment Amount |
57381.86 |
Total Medical Medicare Standardized Payment Amount |
60019.55 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9822 |