National Provider Identifier [NPI]: |
1285945139 |
Last Name Of The Provider |
BAZE |
First Name Of The Provider |
ERIGENA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3554 HULMEVILLE RD |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
BENSALEM |
Zip Code Of The Provider |
190204366 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
1078 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
167050 |
Total Medicare Allowed Amount |
73241.08 |
Total Medicare Payment Amount |
53827.5 |
Total Medicare Standardized Payment Amount |
51466 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
173 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
2990 |
Total Drug Medicare AllowedAmount |
83.65 |
Total Drug Medicare PaymentAmount |
60.02 |
Total Drug Medicare Standardized Payment Amount |
60.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
905 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
164060 |
Total Medical Medicare Allowed Amount |
73157.43 |
Total Medical Medicare Payment Amount |
53767.48 |
Total Medical Medicare Standardized Payment Amount |
51405.98 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
158 |
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 |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6236 |