National Provider Identifier [NPI]: |
1104809482 |
Last Name Of The Provider |
POTERACK |
First Name Of The Provider |
KARL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13400 E SHEA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852595404 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
413 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
99424.02 |
Total Medicare Allowed Amount |
71423.45 |
Total Medicare Payment Amount |
54291.19 |
Total Medicare Standardized Payment Amount |
59447.11 |
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 |
73 |
Number Of Medical Services |
413 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
99424.02 |
Total Medical Medicare Allowed Amount |
71423.45 |
Total Medical Medicare Payment Amount |
54291.19 |
Total Medical Medicare Standardized Payment Amount |
59447.11 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.7075 |