National Provider Identifier [NPI]: |
1962491498 |
Last Name Of The Provider |
HELLINGER |
First Name Of The Provider |
WALTER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 SAN PABLO RD S |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322241865 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
535 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
70360.13 |
Total Medicare Allowed Amount |
57953.56 |
Total Medicare Payment Amount |
43428.59 |
Total Medicare Standardized Payment Amount |
48006.21 |
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 |
12 |
Number Of Medical Services |
535 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
70360.13 |
Total Medical Medicare Allowed Amount |
57953.56 |
Total Medical Medicare Payment Amount |
43428.59 |
Total Medical Medicare Standardized Payment Amount |
48006.21 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
159 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.3047 |