National Provider Identifier [NPI]: |
1194754622 |
Last Name Of The Provider |
BERTRAM |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8251 PINE RD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452362191 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
9894 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
622377 |
Total Medicare Allowed Amount |
353079.32 |
Total Medicare Payment Amount |
272401.48 |
Total Medicare Standardized Payment Amount |
292606.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
2055 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
15805 |
Total Drug Medicare AllowedAmount |
1926.26 |
Total Drug Medicare PaymentAmount |
1487.62 |
Total Drug Medicare Standardized Payment Amount |
1487.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
7839 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
606572 |
Total Medical Medicare Allowed Amount |
351153.06 |
Total Medical Medicare Payment Amount |
270913.86 |
Total Medical Medicare Standardized Payment Amount |
291118.52 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
255 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
280 |
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 |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
215 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2931 |