National Provider Identifier [NPI]: |
1861521460 |
Last Name Of The Provider |
PAVELKA |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3219 CLIFTON AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452203027 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gynecological/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
342 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
121656 |
Total Medicare Allowed Amount |
70193.33 |
Total Medicare Payment Amount |
52622.73 |
Total Medicare Standardized Payment Amount |
55720.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
342 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
121656 |
Total Medical Medicare Allowed Amount |
70193.33 |
Total Medical Medicare Payment Amount |
52622.73 |
Total Medical Medicare Standardized Payment Amount |
55720.6 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
138 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5598 |