National Provider Identifier [NPI]: |
1710932199 |
Last Name Of The Provider |
SKROCKI |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 W. FOREST AVENUE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
FLAGSTAFF |
Zip Code Of The Provider |
860011482 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
230 |
Number Of Services |
9084 |
Number Of Medicare Beneficiaries |
2410 |
Total Submitted Charge Amount |
1245736 |
Total Medicare Allowed Amount |
317247.61 |
Total Medicare Payment Amount |
247380.28 |
Total Medicare Standardized Payment Amount |
251027.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
4858 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
5996.02 |
Total Drug Medicare AllowedAmount |
1815.77 |
Total Drug Medicare PaymentAmount |
1423.57 |
Total Drug Medicare Standardized Payment Amount |
1423.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
221 |
Number Of Medical Services |
4226 |
Number Of Medicare Beneficiaries With Medical Services |
2409 |
Total Medical Submitted Charge Amount |
1239739.98 |
Total Medical Medicare Allowed Amount |
315431.84 |
Total Medical Medicare Payment Amount |
245956.71 |
Total Medical Medicare Standardized Payment Amount |
249603.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
299 |
Number Of Beneficiaries Age 65 to 74 |
1156 |
Number Of Beneficiaries Age 75 to 84 |
681 |
Number Of Beneficiaries Age Greater 84 |
274 |
Number Of Female Beneficiaries |
1441 |
Number Of Male Beneficiaries |
969 |
Number Of Non Hispanic White Beneficiaries |
1676 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
166 |
Number Of American Indian Alaska Native Beneficiaries |
495 |
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
1807 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
603 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4301 |