National Provider Identifier [NPI]: |
1194952358 |
Last Name Of The Provider |
PARUCH |
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 |
1225 GRAHAM RD |
Street Address 2 Of The Provider |
STE 2320C |
City Of The Provider |
FLORISSANT |
Zip Code Of The Provider |
630318012 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
210 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
21293 |
Total Medicare Allowed Amount |
16329.22 |
Total Medicare Payment Amount |
12622.59 |
Total Medicare Standardized Payment Amount |
12840.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1406 |
Total Drug Medicare AllowedAmount |
1331.27 |
Total Drug Medicare PaymentAmount |
1303.23 |
Total Drug Medicare Standardized Payment Amount |
1303.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
172 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
19887 |
Total Medical Medicare Allowed Amount |
14997.95 |
Total Medical Medicare Payment Amount |
11319.36 |
Total Medical Medicare Standardized Payment Amount |
11537.34 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
70 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2151 |