National Provider Identifier [NPI]: |
1881642106 |
Last Name Of The Provider |
GLENER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1599 SE LENNARD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT ST LUCIE |
Zip Code Of The Provider |
349526542 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
3793 |
Number Of Medicare Beneficiaries |
539 |
Total Submitted Charge Amount |
736543 |
Total Medicare Allowed Amount |
280215.9 |
Total Medicare Payment Amount |
211112.1 |
Total Medicare Standardized Payment Amount |
203190.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
776 |
Number Of Medicare Beneficiaries With Drug Services |
185 |
Total Drug Submitted ChargeAmount |
12608 |
Total Drug Medicare AllowedAmount |
1998.06 |
Total Drug Medicare PaymentAmount |
1555.17 |
Total Drug Medicare Standardized Payment Amount |
1555.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
62 |
Number Of Medical Services |
3017 |
Number Of Medicare Beneficiaries With Medical Services |
539 |
Total Medical Submitted Charge Amount |
723935 |
Total Medical Medicare Allowed Amount |
278217.84 |
Total Medical Medicare Payment Amount |
209556.93 |
Total Medical Medicare Standardized Payment Amount |
201635.33 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
219 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
476 |
Number Of Black or African American Beneficiaries |
51 |
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 |
394 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4852 |