National Provider Identifier [NPI]: |
1891791851 |
Last Name Of The Provider |
BILIACK |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
19636 N 27TH AVE |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850274014 |
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 |
8 |
Number Of Services |
644 |
Number Of Medicare Beneficiaries |
310 |
Total Submitted Charge Amount |
488100 |
Total Medicare Allowed Amount |
83655.73 |
Total Medicare Payment Amount |
64182.39 |
Total Medicare Standardized Payment Amount |
66458.14 |
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 |
8 |
Number Of Medical Services |
644 |
Number Of Medicare Beneficiaries With Medical Services |
310 |
Total Medical Submitted Charge Amount |
488100 |
Total Medical Medicare Allowed Amount |
83655.73 |
Total Medical Medicare Payment Amount |
64182.39 |
Total Medical Medicare Standardized Payment Amount |
66458.14 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2831 |