National Provider Identifier [NPI]: |
1578723185 |
Last Name Of The Provider |
SIERADZKI |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
53880 CARMICHAEL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466351567 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
2702 |
Number Of Medicare Beneficiaries |
483 |
Total Submitted Charge Amount |
916448.38 |
Total Medicare Allowed Amount |
194533.35 |
Total Medicare Payment Amount |
146907.77 |
Total Medicare Standardized Payment Amount |
157296.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1002 |
Number Of Medicare Beneficiaries With Drug Services |
137 |
Total Drug Submitted ChargeAmount |
19490.04 |
Total Drug Medicare AllowedAmount |
4870.93 |
Total Drug Medicare PaymentAmount |
3764.6 |
Total Drug Medicare Standardized Payment Amount |
3764.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
1700 |
Number Of Medicare Beneficiaries With Medical Services |
483 |
Total Medical Submitted Charge Amount |
896958.34 |
Total Medical Medicare Allowed Amount |
189662.42 |
Total Medical Medicare Payment Amount |
143143.17 |
Total Medical Medicare Standardized Payment Amount |
153531.77 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
443 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1528 |