National Provider Identifier [NPI]: |
1326163981 |
Last Name Of The Provider |
FABER |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O., M.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4725 E GALBRAITH RD |
Street Address 2 Of The Provider |
STE 320 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452362725 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
70729 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
1621937.46 |
Total Medicare Allowed Amount |
629911.81 |
Total Medicare Payment Amount |
493736.51 |
Total Medicare Standardized Payment Amount |
500402.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
55 |
Number Of Drug Services |
67251 |
Number Of Medicare Beneficiaries With Drug Services |
140 |
Total Drug Submitted ChargeAmount |
1019016.46 |
Total Drug Medicare AllowedAmount |
459859.53 |
Total Drug Medicare PaymentAmount |
360523.63 |
Total Drug Medicare Standardized Payment Amount |
360523.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3478 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
602921 |
Total Medical Medicare Allowed Amount |
170052.28 |
Total Medical Medicare Payment Amount |
133212.88 |
Total Medical Medicare Standardized Payment Amount |
139878.9 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
240 |
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 |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.4403 |