National Provider Identifier [NPI]: |
1801992235 |
Last Name Of The Provider |
ROLF |
First Name Of The Provider |
RYAN |
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 |
7950 W JEFFERSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468044140 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1760 |
Number Of Medicare Beneficiaries |
628 |
Total Submitted Charge Amount |
276139 |
Total Medicare Allowed Amount |
153636.9 |
Total Medicare Payment Amount |
117390.11 |
Total Medicare Standardized Payment Amount |
123494.35 |
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 |
17 |
Number Of Medical Services |
1760 |
Number Of Medicare Beneficiaries With Medical Services |
628 |
Total Medical Submitted Charge Amount |
276139 |
Total Medical Medicare Allowed Amount |
153636.9 |
Total Medical Medicare Payment Amount |
117390.11 |
Total Medical Medicare Standardized Payment Amount |
123494.35 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
152 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
589 |
Number Of Black or African American Beneficiaries |
22 |
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 |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.7946 |