National Provider Identifier [NPI]: |
1568644649 |
Last Name Of The Provider |
WARD |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18205 N 51ST AVE |
Street Address 2 Of The Provider |
SUITE 109 |
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
853081490 |
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 |
45 |
Number Of Services |
127 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
41652.52 |
Total Medicare Allowed Amount |
30924.86 |
Total Medicare Payment Amount |
24139.07 |
Total Medicare Standardized Payment Amount |
24909.42 |
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 |
45 |
Number Of Medical Services |
127 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
41652.52 |
Total Medical Medicare Allowed Amount |
30924.86 |
Total Medical Medicare Payment Amount |
24139.07 |
Total Medical Medicare Standardized Payment Amount |
24909.42 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
97 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
17 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2649 |