National Provider Identifier [NPI]: |
1083704845 |
Last Name Of The Provider |
FLESZAR |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3430 TAMIAMI TRL |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
PORT CHARLOTTE |
Zip Code Of The Provider |
339528148 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
218 |
Number Of Services |
67820 |
Number Of Medicare Beneficiaries |
5669 |
Total Submitted Charge Amount |
2336187.87 |
Total Medicare Allowed Amount |
1083806.29 |
Total Medicare Payment Amount |
840571.72 |
Total Medicare Standardized Payment Amount |
865028.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
58943 |
Number Of Medicare Beneficiaries With Drug Services |
794 |
Total Drug Submitted ChargeAmount |
29952.12 |
Total Drug Medicare AllowedAmount |
15441.39 |
Total Drug Medicare PaymentAmount |
12021.87 |
Total Drug Medicare Standardized Payment Amount |
12021.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
214 |
Number Of Medical Services |
8877 |
Number Of Medicare Beneficiaries With Medical Services |
5668 |
Total Medical Submitted Charge Amount |
2306235.75 |
Total Medical Medicare Allowed Amount |
1068364.9 |
Total Medical Medicare Payment Amount |
828549.85 |
Total Medical Medicare Standardized Payment Amount |
853006.44 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
418 |
Number Of Beneficiaries Age 65 to 74 |
2677 |
Number Of Beneficiaries Age 75 to 84 |
1879 |
Number Of Beneficiaries Age Greater 84 |
695 |
Number Of Female Beneficiaries |
3430 |
Number Of Male Beneficiaries |
2239 |
Number Of Non Hispanic White Beneficiaries |
5322 |
Number Of Black or African American Beneficiaries |
132 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
115 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
83 |
Number Of Beneficiaries With Medicare Only Entitlement |
5311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
358 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.129 |