National Provider Identifier [NPI]: |
1114960408 |
Last Name Of The Provider |
DRANCIK |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
710 N EAST ST |
Street Address 2 Of The Provider |
WABASH COUNTY HOSPITAL |
City Of The Provider |
WABASH |
Zip Code Of The Provider |
469921914 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
599 |
Number Of Medicare Beneficiaries |
203 |
Total Submitted Charge Amount |
154095 |
Total Medicare Allowed Amount |
61687.95 |
Total Medicare Payment Amount |
47429.32 |
Total Medicare Standardized Payment Amount |
42194.7 |
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 |
22 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
203 |
Total Medical Submitted Charge Amount |
154095 |
Total Medical Medicare Allowed Amount |
61687.95 |
Total Medical Medicare Payment Amount |
47429.32 |
Total Medical Medicare Standardized Payment Amount |
42194.7 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4154 |