National Provider Identifier [NPI]: |
1639179963 |
Last Name Of The Provider |
BARLEKAMP |
First Name Of The Provider |
HAROLD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4411 N HOLLAND SYLVANIA RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436233525 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
434 |
Number Of Medicare Beneficiaries |
97 |
Total Submitted Charge Amount |
44826.43 |
Total Medicare Allowed Amount |
29379.12 |
Total Medicare Payment Amount |
19425.5 |
Total Medicare Standardized Payment Amount |
20764.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1573 |
Total Drug Medicare AllowedAmount |
1098.36 |
Total Drug Medicare PaymentAmount |
1056.09 |
Total Drug Medicare Standardized Payment Amount |
1056.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
351 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
43253.43 |
Total Medical Medicare Allowed Amount |
28280.76 |
Total Medical Medicare Payment Amount |
18369.41 |
Total Medical Medicare Standardized Payment Amount |
19708.44 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
52 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
86 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8395 |