National Provider Identifier [NPI]: |
1306830740 |
Last Name Of The Provider |
RALSTON |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5255 E STOP 11 RD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462376340 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
918 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
201816 |
Total Medicare Allowed Amount |
92649.16 |
Total Medicare Payment Amount |
70249.42 |
Total Medicare Standardized Payment Amount |
75515.15 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7173 |