National Provider Identifier [NPI]: |
1124023387 |
Last Name Of The Provider |
UCHMAN |
First Name Of The Provider |
BOGUSLAW |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 N MADISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANDERSON |
Zip Code Of The Provider |
460113453 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
2268 |
Number Of Medicare Beneficiaries |
928 |
Total Submitted Charge Amount |
270873 |
Total Medicare Allowed Amount |
71182.17 |
Total Medicare Payment Amount |
55223.14 |
Total Medicare Standardized Payment Amount |
46053.04 |
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 |
41 |
Number Of Medical Services |
2268 |
Number Of Medicare Beneficiaries With Medical Services |
928 |
Total Medical Submitted Charge Amount |
270873 |
Total Medical Medicare Allowed Amount |
71182.17 |
Total Medical Medicare Payment Amount |
55223.14 |
Total Medical Medicare Standardized Payment Amount |
46053.04 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
176 |
Number Of Beneficiaries Age 65 to 74 |
398 |
Number Of Beneficiaries Age 75 to 84 |
258 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
517 |
Number Of Male Beneficiaries |
411 |
Number Of Non Hispanic White Beneficiaries |
827 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
730 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5608 |