National Provider Identifier [NPI]: |
1972540367 |
Last Name Of The Provider |
STECK |
First Name Of The Provider |
JEROME |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6567 E CARONDELET DR |
Street Address 2 Of The Provider |
SUITE 415 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857102156 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
104 |
Number Of Services |
1511 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
590083 |
Total Medicare Allowed Amount |
186419.08 |
Total Medicare Payment Amount |
139474.21 |
Total Medicare Standardized Payment Amount |
141096.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
253 |
Total Drug Medicare AllowedAmount |
42.08 |
Total Drug Medicare PaymentAmount |
30.84 |
Total Drug Medicare Standardized Payment Amount |
30.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
102 |
Number Of Medical Services |
1497 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
589830 |
Total Medical Medicare Allowed Amount |
186377 |
Total Medical Medicare Payment Amount |
139443.37 |
Total Medical Medicare Standardized Payment Amount |
141066.15 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
277 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4844 |