National Provider Identifier [NPI]: |
1255300281 |
Last Name Of The Provider |
BRUNO |
First Name Of The Provider |
JOANNA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6046 WHIPPLE AVE NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH CANTON |
Zip Code Of The Provider |
44720 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
154 |
Number Of Services |
15638 |
Number Of Medicare Beneficiaries |
2101 |
Total Submitted Charge Amount |
395549.05 |
Total Medicare Allowed Amount |
237433.39 |
Total Medicare Payment Amount |
212964.26 |
Total Medicare Standardized Payment Amount |
217146.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
700 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
12877.3 |
Total Drug Medicare AllowedAmount |
8332.71 |
Total Drug Medicare PaymentAmount |
7115.31 |
Total Drug Medicare Standardized Payment Amount |
7115.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
143 |
Number Of Medical Services |
14938 |
Number Of Medicare Beneficiaries With Medical Services |
2101 |
Total Medical Submitted Charge Amount |
382671.75 |
Total Medical Medicare Allowed Amount |
229100.68 |
Total Medical Medicare Payment Amount |
205848.95 |
Total Medical Medicare Standardized Payment Amount |
210031.63 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
274 |
Number Of Beneficiaries Age 65 to 74 |
850 |
Number Of Beneficiaries Age 75 to 84 |
618 |
Number Of Beneficiaries Age Greater 84 |
359 |
Number Of Female Beneficiaries |
1138 |
Number Of Male Beneficiaries |
963 |
Number Of Non Hispanic White Beneficiaries |
1975 |
Number Of Black or African American Beneficiaries |
84 |
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 |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
1806 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
295 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.297 |