National Provider Identifier [NPI]: |
1902913312 |
Last Name Of The Provider |
RUDOLPH |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1880 MEASE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAFETY HARBOR |
Zip Code Of The Provider |
346954659 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
173 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
284076.58 |
Total Medicare Allowed Amount |
21045.24 |
Total Medicare Payment Amount |
16249.68 |
Total Medicare Standardized Payment Amount |
15904.84 |
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 |
46 |
Number Of Medical Services |
173 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
284076.58 |
Total Medical Medicare Allowed Amount |
21045.24 |
Total Medical Medicare Payment Amount |
16249.68 |
Total Medical Medicare Standardized Payment Amount |
15904.84 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6388 |