National Provider Identifier [NPI]: |
1336296789 |
Last Name Of The Provider |
SPIVACK |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21110 BISCAYNE BLVD |
Street Address 2 Of The Provider |
STE 208 |
City Of The Provider |
AVENTURA |
Zip Code Of The Provider |
331801251 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
4933 |
Number Of Medicare Beneficiaries |
799 |
Total Submitted Charge Amount |
843026.35 |
Total Medicare Allowed Amount |
443490.17 |
Total Medicare Payment Amount |
334530.62 |
Total Medicare Standardized Payment Amount |
316308.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
518 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
13780 |
Total Drug Medicare AllowedAmount |
1017.24 |
Total Drug Medicare PaymentAmount |
946.48 |
Total Drug Medicare Standardized Payment Amount |
946.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
4415 |
Number Of Medicare Beneficiaries With Medical Services |
798 |
Total Medical Submitted Charge Amount |
829246.35 |
Total Medical Medicare Allowed Amount |
442472.93 |
Total Medical Medicare Payment Amount |
333584.14 |
Total Medical Medicare Standardized Payment Amount |
315361.87 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
234 |
Number Of Beneficiaries Age Greater 84 |
244 |
Number Of Female Beneficiaries |
457 |
Number Of Male Beneficiaries |
342 |
Number Of Non Hispanic White Beneficiaries |
560 |
Number Of Black or African American Beneficiaries |
124 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
540 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
259 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1769 |