National Provider Identifier [NPI]: |
1093815565 |
Last Name Of The Provider |
SCHLAKMAN |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 N STATE STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
39216 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1049 |
Number Of Medicare Beneficiaries |
817 |
Total Submitted Charge Amount |
366126 |
Total Medicare Allowed Amount |
80675.03 |
Total Medicare Payment Amount |
61110.29 |
Total Medicare Standardized Payment Amount |
65501.68 |
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 |
32 |
Number Of Medical Services |
1049 |
Number Of Medicare Beneficiaries With Medical Services |
817 |
Total Medical Submitted Charge Amount |
366126 |
Total Medical Medicare Allowed Amount |
80675.03 |
Total Medical Medicare Payment Amount |
61110.29 |
Total Medical Medicare Standardized Payment Amount |
65501.68 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
321 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
455 |
Number Of Male Beneficiaries |
362 |
Number Of Non Hispanic White Beneficiaries |
445 |
Number Of Black or African American Beneficiaries |
361 |
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 |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
362 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.4195 |