National Provider Identifier [NPI]: |
1396741096 |
Last Name Of The Provider |
BEACH |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
106 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DRY RIDGE |
Zip Code Of The Provider |
410359406 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1488 |
Number Of Medicare Beneficiaries |
425 |
Total Submitted Charge Amount |
49857.48 |
Total Medicare Allowed Amount |
49306.48 |
Total Medicare Payment Amount |
34699.9 |
Total Medicare Standardized Payment Amount |
45650.7 |
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 |
14 |
Number Of Medical Services |
1488 |
Number Of Medicare Beneficiaries With Medical Services |
425 |
Total Medical Submitted Charge Amount |
49857.48 |
Total Medical Medicare Allowed Amount |
49306.48 |
Total Medical Medicare Payment Amount |
34699.9 |
Total Medical Medicare Standardized Payment Amount |
45650.7 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
303 |
Number Of Male Beneficiaries |
122 |
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 |
239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
53 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9046 |