National Provider Identifier [NPI]: |
1659332054 |
Last Name Of The Provider |
STADNICK |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
335 GLESSNER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANSFIELD |
Zip Code Of The Provider |
449032269 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
939 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
104101 |
Total Medicare Allowed Amount |
63292.09 |
Total Medicare Payment Amount |
44681.15 |
Total Medicare Standardized Payment Amount |
46538.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
2130 |
Total Drug Medicare AllowedAmount |
430.26 |
Total Drug Medicare PaymentAmount |
328.42 |
Total Drug Medicare Standardized Payment Amount |
328.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
797 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
101971 |
Total Medical Medicare Allowed Amount |
62861.83 |
Total Medical Medicare Payment Amount |
44352.73 |
Total Medical Medicare Standardized Payment Amount |
46209.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
337 |
Number Of Black or African American Beneficiaries |
|
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 |
299 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3442 |