National Provider Identifier [NPI]: |
1831392083 |
Last Name Of The Provider |
CONRAD |
First Name Of The Provider |
MILES |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 N CAMPBELL AVE |
Street Address 2 Of The Provider |
DEPT. OF RADIOLOGY |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857240001 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
776 |
Number Of Medicare Beneficiaries |
227 |
Total Submitted Charge Amount |
1046007.6 |
Total Medicare Allowed Amount |
91854.02 |
Total Medicare Payment Amount |
71588.93 |
Total Medicare Standardized Payment Amount |
64777.52 |
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 |
108 |
Number Of Medical Services |
776 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
1046007.6 |
Total Medical Medicare Allowed Amount |
91854.02 |
Total Medical Medicare Payment Amount |
71588.93 |
Total Medical Medicare Standardized Payment Amount |
64777.52 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
57 |
Number Of Black or African American Beneficiaries |
57 |
Number Of AsianPacific Islander Beneficiaries |
61 |
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 |
39 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
188 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
3.7578 |