National Provider Identifier [NPI]: |
1174781496 |
Last Name Of The Provider |
HOLCOMB |
First Name Of The Provider |
BRYAN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
545 BARNHILL DR. |
Street Address 2 Of The Provider |
EH 500 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462025112 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
464 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
278129 |
Total Medicare Allowed Amount |
102437.52 |
Total Medicare Payment Amount |
77561.63 |
Total Medicare Standardized Payment Amount |
86589.94 |
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 |
93 |
Number Of Medical Services |
464 |
Number Of Medicare Beneficiaries With Medical Services |
209 |
Total Medical Submitted Charge Amount |
278129 |
Total Medical Medicare Allowed Amount |
102437.52 |
Total Medical Medicare Payment Amount |
77561.63 |
Total Medical Medicare Standardized Payment Amount |
86589.94 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
149 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1369 |