National Provider Identifier [NPI]: |
1134134612 |
Last Name Of The Provider |
STEDJE |
First Name Of The Provider |
KURT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 PHILADELPHIA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454061813 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
207 |
Number Of Services |
4387 |
Number Of Medicare Beneficiaries |
2758 |
Total Submitted Charge Amount |
623834 |
Total Medicare Allowed Amount |
151864.82 |
Total Medicare Payment Amount |
117718.55 |
Total Medicare Standardized Payment Amount |
120832.74 |
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 |
207 |
Number Of Medical Services |
4387 |
Number Of Medicare Beneficiaries With Medical Services |
2758 |
Total Medical Submitted Charge Amount |
623834 |
Total Medical Medicare Allowed Amount |
151864.82 |
Total Medical Medicare Payment Amount |
117718.55 |
Total Medical Medicare Standardized Payment Amount |
120832.74 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
579 |
Number Of Beneficiaries Age 65 to 74 |
1018 |
Number Of Beneficiaries Age 75 to 84 |
767 |
Number Of Beneficiaries Age Greater 84 |
394 |
Number Of Female Beneficiaries |
1718 |
Number Of Male Beneficiaries |
1040 |
Number Of Non Hispanic White Beneficiaries |
1952 |
Number Of Black or African American Beneficiaries |
755 |
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 |
27 |
Number Of Beneficiaries With Medicare Only Entitlement |
1992 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
766 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7978 |