National Provider Identifier [NPI]: |
1073557500 |
Last Name Of The Provider |
HERGENROTHER |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2123 AUBURN AVE |
Street Address 2 Of The Provider |
#404 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452192906 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2708 |
Number Of Medicare Beneficiaries |
637 |
Total Submitted Charge Amount |
562673 |
Total Medicare Allowed Amount |
330410.23 |
Total Medicare Payment Amount |
252082.92 |
Total Medicare Standardized Payment Amount |
259059.54 |
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 |
29 |
Number Of Medical Services |
2708 |
Number Of Medicare Beneficiaries With Medical Services |
637 |
Total Medical Submitted Charge Amount |
562673 |
Total Medical Medicare Allowed Amount |
330410.23 |
Total Medical Medicare Payment Amount |
252082.92 |
Total Medical Medicare Standardized Payment Amount |
259059.54 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
197 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
292 |
Number Of Male Beneficiaries |
345 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
196 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
217 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
4.6875 |