National Provider Identifier [NPI]: |
1073512695 |
Last Name Of The Provider |
CASE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2866 TAMIAMI TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT CHARLOTTE |
Zip Code Of The Provider |
339525126 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
2088 |
Number Of Medicare Beneficiaries |
457 |
Total Submitted Charge Amount |
158419 |
Total Medicare Allowed Amount |
115264.21 |
Total Medicare Payment Amount |
87194.6 |
Total Medicare Standardized Payment Amount |
87926.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
296 |
Total Drug Medicare AllowedAmount |
110.92 |
Total Drug Medicare PaymentAmount |
82.7 |
Total Drug Medicare Standardized Payment Amount |
82.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
2051 |
Number Of Medicare Beneficiaries With Medical Services |
457 |
Total Medical Submitted Charge Amount |
158123 |
Total Medical Medicare Allowed Amount |
115153.29 |
Total Medical Medicare Payment Amount |
87111.9 |
Total Medical Medicare Standardized Payment Amount |
87844.22 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
430 |
Number Of Black or African American Beneficiaries |
13 |
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 |
392 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7032 |