National Provider Identifier [NPI]: |
1437152691 |
Last Name Of The Provider |
KRUEGER |
First Name Of The Provider |
SYLVIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2390 N OCOEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
373113850 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
154 |
Number Of Services |
198017 |
Number Of Medicare Beneficiaries |
661 |
Total Submitted Charge Amount |
4806203 |
Total Medicare Allowed Amount |
3174591.8 |
Total Medicare Payment Amount |
2488664.95 |
Total Medicare Standardized Payment Amount |
2497998.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
75 |
Number Of Drug Services |
179616 |
Number Of Medicare Beneficiaries With Drug Services |
198 |
Total Drug Submitted ChargeAmount |
3479900 |
Total Drug Medicare AllowedAmount |
2663797.46 |
Total Drug Medicare PaymentAmount |
2081188.69 |
Total Drug Medicare Standardized Payment Amount |
2081188.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
18401 |
Number Of Medicare Beneficiaries With Medical Services |
661 |
Total Medical Submitted Charge Amount |
1326303 |
Total Medical Medicare Allowed Amount |
510794.34 |
Total Medical Medicare Payment Amount |
407476.26 |
Total Medical Medicare Standardized Payment Amount |
416809.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
291 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
385 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
629 |
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 |
476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8978 |