National Provider Identifier [NPI]: |
1609854942 |
Last Name Of The Provider |
BERDY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7640 SYLVANIA AVE |
Street Address 2 Of The Provider |
SUITE K |
City Of The Provider |
SYLVANIA |
Zip Code Of The Provider |
435609729 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
550 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
86714 |
Total Medicare Allowed Amount |
36376.53 |
Total Medicare Payment Amount |
25489.04 |
Total Medicare Standardized Payment Amount |
24370.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1646 |
Total Drug Medicare AllowedAmount |
835.4 |
Total Drug Medicare PaymentAmount |
803.99 |
Total Drug Medicare Standardized Payment Amount |
803.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
492 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
85068 |
Total Medical Medicare Allowed Amount |
35541.13 |
Total Medical Medicare Payment Amount |
24685.05 |
Total Medical Medicare Standardized Payment Amount |
23566.94 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
45 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
133 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
68 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2756 |