National Provider Identifier [NPI]: |
1013995554 |
Last Name Of The Provider |
BORUCKI |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
124 BLUFF SPRING DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
357587386 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2221 |
Number Of Medicare Beneficiaries |
1373 |
Total Submitted Charge Amount |
1462370 |
Total Medicare Allowed Amount |
221547.43 |
Total Medicare Payment Amount |
169297.52 |
Total Medicare Standardized Payment Amount |
179963.7 |
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 |
30 |
Number Of Medical Services |
2221 |
Number Of Medicare Beneficiaries With Medical Services |
1373 |
Total Medical Submitted Charge Amount |
1462370 |
Total Medical Medicare Allowed Amount |
221547.43 |
Total Medical Medicare Payment Amount |
169297.52 |
Total Medical Medicare Standardized Payment Amount |
179963.7 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
431 |
Number Of Beneficiaries Age 65 to 74 |
378 |
Number Of Beneficiaries Age 75 to 84 |
374 |
Number Of Beneficiaries Age Greater 84 |
190 |
Number Of Female Beneficiaries |
793 |
Number Of Male Beneficiaries |
580 |
Number Of Non Hispanic White Beneficiaries |
1265 |
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 |
834 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
539 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6296 |