National Provider Identifier [NPI]: |
1841433265 |
Last Name Of The Provider |
DONCA |
First Name Of The Provider |
IONEL |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10665 BLUEBERRY HILL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
KIRTLAND |
Zip Code Of The Provider |
440945501 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1725 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
332325.21 |
Total Medicare Allowed Amount |
165970.08 |
Total Medicare Payment Amount |
127704.02 |
Total Medicare Standardized Payment Amount |
130361.89 |
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 |
25 |
Number Of Medical Services |
1725 |
Number Of Medicare Beneficiaries With Medical Services |
380 |
Total Medical Submitted Charge Amount |
332325.21 |
Total Medical Medicare Allowed Amount |
165970.08 |
Total Medical Medicare Payment Amount |
127704.02 |
Total Medical Medicare Standardized Payment Amount |
130361.89 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
313 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
60 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4684 |