National Provider Identifier [NPI]: |
1255334124 |
Last Name Of The Provider |
FITZKE |
First Name Of The Provider |
GREG |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
575 S 70TH ST |
Street Address 2 Of The Provider |
STE 310 |
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685102471 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
677 |
Number Of Medicare Beneficiaries |
299 |
Total Submitted Charge Amount |
374925.54 |
Total Medicare Allowed Amount |
171134.8 |
Total Medicare Payment Amount |
133052.43 |
Total Medicare Standardized Payment Amount |
145159.67 |
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 |
108 |
Number Of Medical Services |
677 |
Number Of Medicare Beneficiaries With Medical Services |
299 |
Total Medical Submitted Charge Amount |
374925.54 |
Total Medical Medicare Allowed Amount |
171134.8 |
Total Medical Medicare Payment Amount |
133052.43 |
Total Medical Medicare Standardized Payment Amount |
145159.67 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
285 |
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 |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2449 |