National Provider Identifier [NPI]: |
1972560126 |
Last Name Of The Provider |
ROSEN |
First Name Of The Provider |
STANFORD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 RESTON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUSCALOOSA |
Zip Code Of The Provider |
354062043 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
2574 |
Number Of Medicare Beneficiaries |
577 |
Total Submitted Charge Amount |
114989.57 |
Total Medicare Allowed Amount |
107330.63 |
Total Medicare Payment Amount |
79838.77 |
Total Medicare Standardized Payment Amount |
90046.24 |
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 |
23 |
Number Of Medical Services |
2574 |
Number Of Medicare Beneficiaries With Medical Services |
577 |
Total Medical Submitted Charge Amount |
114989.57 |
Total Medical Medicare Allowed Amount |
107330.63 |
Total Medical Medicare Payment Amount |
79838.77 |
Total Medical Medicare Standardized Payment Amount |
90046.24 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
230 |
Number Of Female Beneficiaries |
414 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
406 |
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 |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
444 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
74 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1698 |