National Provider Identifier [NPI]: |
1437145786 |
Last Name Of The Provider |
GLECKMAN |
First Name Of The Provider |
ARI |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 PENNSYLVANIA PKWY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462802301 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
1119 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
184985 |
Total Medicare Allowed Amount |
84526.93 |
Total Medicare Payment Amount |
63213.16 |
Total Medicare Standardized Payment Amount |
64604.33 |
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 |
5 |
Number Of Medical Services |
1119 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
184985 |
Total Medical Medicare Allowed Amount |
84526.93 |
Total Medical Medicare Payment Amount |
63213.16 |
Total Medical Medicare Standardized Payment Amount |
64604.33 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
184 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
244 |
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 |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4886 |