National Provider Identifier [NPI]: |
1750349270 |
Last Name Of The Provider |
LANZOTTI |
First Name Of The Provider |
VICTOR |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
747 N RUTLEDGE ST |
Street Address 2 Of The Provider |
2204 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627026700 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
102 |
Number Of Services |
38580 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
518624.6 |
Total Medicare Allowed Amount |
484660.92 |
Total Medicare Payment Amount |
378318.62 |
Total Medicare Standardized Payment Amount |
377419.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
49 |
Number Of Drug Services |
34822 |
Number Of Medicare Beneficiaries With Drug Services |
101 |
Total Drug Submitted ChargeAmount |
315249.6 |
Total Drug Medicare AllowedAmount |
306006.22 |
Total Drug Medicare PaymentAmount |
239760.85 |
Total Drug Medicare Standardized Payment Amount |
239760.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
3758 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
203375 |
Total Medical Medicare Allowed Amount |
178654.7 |
Total Medical Medicare Payment Amount |
138557.77 |
Total Medical Medicare Standardized Payment Amount |
137658.53 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
305 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
265 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
47 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.1112 |