National Provider Identifier [NPI]: |
1457322976 |
Last Name Of The Provider |
CHRISTIE |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5330 E STOP 11 RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462376345 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
2891 |
Number Of Medicare Beneficiaries |
1680 |
Total Submitted Charge Amount |
486033 |
Total Medicare Allowed Amount |
218515.25 |
Total Medicare Payment Amount |
160695.81 |
Total Medicare Standardized Payment Amount |
170562.28 |
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 |
71 |
Number Of Medical Services |
2891 |
Number Of Medicare Beneficiaries With Medical Services |
1680 |
Total Medical Submitted Charge Amount |
486033 |
Total Medical Medicare Allowed Amount |
218515.25 |
Total Medical Medicare Payment Amount |
160695.81 |
Total Medical Medicare Standardized Payment Amount |
170562.28 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
524 |
Number Of Beneficiaries Age 75 to 84 |
653 |
Number Of Beneficiaries Age Greater 84 |
356 |
Number Of Female Beneficiaries |
789 |
Number Of Male Beneficiaries |
891 |
Number Of Non Hispanic White Beneficiaries |
1629 |
Number Of Black or African American Beneficiaries |
12 |
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 |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1441 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
239 |
Percent Of With Atrial Fibrillation |
44 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6944 |