National Provider Identifier [NPI]: |
1811987514 |
Last Name Of The Provider |
BRODELL |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3900 ST FRANCIS WAY STE 205 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479054939 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
4113 |
Number Of Medicare Beneficiaries |
1803 |
Total Submitted Charge Amount |
1367933 |
Total Medicare Allowed Amount |
307389.36 |
Total Medicare Payment Amount |
229584.09 |
Total Medicare Standardized Payment Amount |
244896.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
124 |
Number Of Medicare Beneficiaries With Drug Services |
39 |
Total Drug Submitted ChargeAmount |
17846 |
Total Drug Medicare AllowedAmount |
6566.8 |
Total Drug Medicare PaymentAmount |
4981.79 |
Total Drug Medicare Standardized Payment Amount |
4981.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
3989 |
Number Of Medicare Beneficiaries With Medical Services |
1802 |
Total Medical Submitted Charge Amount |
1350087 |
Total Medical Medicare Allowed Amount |
300822.56 |
Total Medical Medicare Payment Amount |
224602.3 |
Total Medical Medicare Standardized Payment Amount |
239915.12 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
218 |
Number Of Beneficiaries Age 65 to 74 |
658 |
Number Of Beneficiaries Age 75 to 84 |
638 |
Number Of Beneficiaries Age Greater 84 |
289 |
Number Of Female Beneficiaries |
908 |
Number Of Male Beneficiaries |
895 |
Number Of Non Hispanic White Beneficiaries |
1754 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1524 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
279 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5256 |