National Provider Identifier [NPI]: |
1811916729 |
Last Name Of The Provider |
ZIMMET |
First Name Of The Provider |
GLENN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1613 NW 136TH AVE |
Street Address 2 Of The Provider |
#200 |
City Of The Provider |
SUNRISE |
Zip Code Of The Provider |
333232853 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
72 |
Number Of Medicare Beneficiaries |
64 |
Total Submitted Charge Amount |
111429 |
Total Medicare Allowed Amount |
12675.98 |
Total Medicare Payment Amount |
9853.62 |
Total Medicare Standardized Payment Amount |
9661.52 |
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 |
27 |
Number Of Medical Services |
72 |
Number Of Medicare Beneficiaries With Medical Services |
64 |
Total Medical Submitted Charge Amount |
111429 |
Total Medical Medicare Allowed Amount |
12675.98 |
Total Medical Medicare Payment Amount |
9853.62 |
Total Medical Medicare Standardized Payment Amount |
9661.52 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
23 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
53 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
|
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6684 |