National Provider Identifier [NPI]: |
1104899004 |
Last Name Of The Provider |
JERAS |
First Name Of The Provider |
VJEKOSLAV |
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 |
25001 EMERY RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441285626 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
2593 |
Number Of Medicare Beneficiaries |
1918 |
Total Submitted Charge Amount |
916813 |
Total Medicare Allowed Amount |
140011.09 |
Total Medicare Payment Amount |
107643.19 |
Total Medicare Standardized Payment Amount |
111509.38 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
291 |
Number Of Beneficiaries Age 65 to 74 |
739 |
Number Of Beneficiaries Age 75 to 84 |
535 |
Number Of Beneficiaries Age Greater 84 |
353 |
Number Of Female Beneficiaries |
1134 |
Number Of Male Beneficiaries |
784 |
Number Of Non Hispanic White Beneficiaries |
1776 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
1537 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
381 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6294 |