National Provider Identifier [NPI]: |
1720068299 |
Last Name Of The Provider |
MEDNICK |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9333 SW 152ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VILLAGE OF PALMETTO BAY |
Zip Code Of The Provider |
331571778 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
222 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
131688 |
Total Medicare Allowed Amount |
36288.06 |
Total Medicare Payment Amount |
26298.43 |
Total Medicare Standardized Payment Amount |
23706.5 |
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 |
9 |
Number Of Medical Services |
222 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
131688 |
Total Medical Medicare Allowed Amount |
36288.06 |
Total Medical Medicare Payment Amount |
26298.43 |
Total Medical Medicare Standardized Payment Amount |
23706.5 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
51 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
45 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
3.0448 |