National Provider Identifier [NPI]: |
1548493448 |
Last Name Of The Provider |
HARRIS |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 W 86TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462601902 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
254 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
257477.2 |
Total Medicare Allowed Amount |
57411.96 |
Total Medicare Payment Amount |
44823.81 |
Total Medicare Standardized Payment Amount |
47113.23 |
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 |
79 |
Number Of Medical Services |
254 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
257477.2 |
Total Medical Medicare Allowed Amount |
57411.96 |
Total Medical Medicare Payment Amount |
44823.81 |
Total Medical Medicare Standardized Payment Amount |
47113.23 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
159 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9367 |