National Provider Identifier [NPI]: |
1982760369 |
Last Name Of The Provider |
BALANDRA |
First Name Of The Provider |
ARTURO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26800 S TAMIAMI TRL |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
BONITA SPRINGS |
Zip Code Of The Provider |
341344349 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
8711 |
Number Of Medicare Beneficiaries |
1013 |
Total Submitted Charge Amount |
1925293.68 |
Total Medicare Allowed Amount |
471664.49 |
Total Medicare Payment Amount |
357210.94 |
Total Medicare Standardized Payment Amount |
343144.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
3639 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
332828.13 |
Total Drug Medicare AllowedAmount |
85090.43 |
Total Drug Medicare PaymentAmount |
66524.07 |
Total Drug Medicare Standardized Payment Amount |
66524.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
5072 |
Number Of Medicare Beneficiaries With Medical Services |
1013 |
Total Medical Submitted Charge Amount |
1592465.55 |
Total Medical Medicare Allowed Amount |
386574.06 |
Total Medical Medicare Payment Amount |
290686.87 |
Total Medical Medicare Standardized Payment Amount |
276620.51 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
428 |
Number Of Beneficiaries Age 75 to 84 |
407 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
841 |
Number Of Non Hispanic White Beneficiaries |
877 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
89 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
920 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1148 |