National Provider Identifier [NPI]: |
1750480448 |
Last Name Of The Provider |
PAVLUK |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
960 CLAGUE RD STE 3201 |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTLAKE |
Zip Code Of The Provider |
441451588 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2067 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
235494 |
Total Medicare Allowed Amount |
167631.88 |
Total Medicare Payment Amount |
127347.58 |
Total Medicare Standardized Payment Amount |
132536.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
239 |
Number Of Medicare Beneficiaries With Drug Services |
198 |
Total Drug Submitted ChargeAmount |
13423 |
Total Drug Medicare AllowedAmount |
8944.62 |
Total Drug Medicare PaymentAmount |
8758.57 |
Total Drug Medicare Standardized Payment Amount |
8758.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1828 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
222071 |
Total Medical Medicare Allowed Amount |
158687.26 |
Total Medical Medicare Payment Amount |
118589.01 |
Total Medical Medicare Standardized Payment Amount |
123777.97 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
375 |
Number Of Black or African American Beneficiaries |
|
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1275 |