National Provider Identifier [NPI]: |
1285792754 |
Last Name Of The Provider |
GERSTLE |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 MEDICAL CAMPUS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
TRAVERSE CITY |
Zip Code Of The Provider |
496847823 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
980 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
134574.64 |
Total Medicare Allowed Amount |
77008.47 |
Total Medicare Payment Amount |
57724.48 |
Total Medicare Standardized Payment Amount |
59828.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1685.2 |
Total Drug Medicare AllowedAmount |
740.75 |
Total Drug Medicare PaymentAmount |
719.57 |
Total Drug Medicare Standardized Payment Amount |
719.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
943 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
132889.44 |
Total Medical Medicare Allowed Amount |
76267.72 |
Total Medical Medicare Payment Amount |
57004.91 |
Total Medical Medicare Standardized Payment Amount |
59109.14 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
172 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
346 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
24 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
239 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6114 |