National Provider Identifier [NPI]: |
1396759676 |
Last Name Of The Provider |
BUNDSCHU |
First Name Of The Provider |
CLAUDIA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 SEVENTH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337051300 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
161 |
Number Of Services |
8889 |
Number Of Medicare Beneficiaries |
2427 |
Total Submitted Charge Amount |
637476.8 |
Total Medicare Allowed Amount |
220074.75 |
Total Medicare Payment Amount |
172488.55 |
Total Medicare Standardized Payment Amount |
174862.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
4460 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
7952.8 |
Total Drug Medicare AllowedAmount |
1414.28 |
Total Drug Medicare PaymentAmount |
1063.71 |
Total Drug Medicare Standardized Payment Amount |
1063.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
159 |
Number Of Medical Services |
4429 |
Number Of Medicare Beneficiaries With Medical Services |
2427 |
Total Medical Submitted Charge Amount |
629524 |
Total Medical Medicare Allowed Amount |
218660.47 |
Total Medical Medicare Payment Amount |
171424.84 |
Total Medical Medicare Standardized Payment Amount |
173798.81 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
415 |
Number Of Beneficiaries Age 65 to 74 |
878 |
Number Of Beneficiaries Age 75 to 84 |
688 |
Number Of Beneficiaries Age Greater 84 |
446 |
Number Of Female Beneficiaries |
1682 |
Number Of Male Beneficiaries |
745 |
Number Of Non Hispanic White Beneficiaries |
1940 |
Number Of Black or African American Beneficiaries |
366 |
Number Of AsianPacific Islander Beneficiaries |
39 |
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1756 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
671 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0061 |