National Provider Identifier [NPI]: |
1407867047 |
Last Name Of The Provider |
HAMILTON |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1818 CAREW ST |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468054788 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
3830 |
Number Of Medicare Beneficiaries |
620 |
Total Submitted Charge Amount |
824316 |
Total Medicare Allowed Amount |
219865.36 |
Total Medicare Payment Amount |
161284.18 |
Total Medicare Standardized Payment Amount |
169869.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1036 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
110027 |
Total Drug Medicare AllowedAmount |
40133.39 |
Total Drug Medicare PaymentAmount |
31279.87 |
Total Drug Medicare Standardized Payment Amount |
31279.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
2794 |
Number Of Medicare Beneficiaries With Medical Services |
620 |
Total Medical Submitted Charge Amount |
714289 |
Total Medical Medicare Allowed Amount |
179731.97 |
Total Medical Medicare Payment Amount |
130004.31 |
Total Medical Medicare Standardized Payment Amount |
138589.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
461 |
Number Of Non Hispanic White Beneficiaries |
556 |
Number Of Black or African American Beneficiaries |
45 |
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 |
528 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3464 |