National Provider Identifier [NPI]: |
1902844756 |
Last Name Of The Provider |
YNGSTROM |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 RANDALLIA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468054638 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
114 |
Number Of Services |
6522 |
Number Of Medicare Beneficiaries |
3625 |
Total Submitted Charge Amount |
575573 |
Total Medicare Allowed Amount |
152560.19 |
Total Medicare Payment Amount |
114042.34 |
Total Medicare Standardized Payment Amount |
120783.4 |
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 |
114 |
Number Of Medical Services |
6522 |
Number Of Medicare Beneficiaries With Medical Services |
3625 |
Total Medical Submitted Charge Amount |
575573 |
Total Medical Medicare Allowed Amount |
152560.19 |
Total Medical Medicare Payment Amount |
114042.34 |
Total Medical Medicare Standardized Payment Amount |
120783.4 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
950 |
Number Of Beneficiaries Age 65 to 74 |
1009 |
Number Of Beneficiaries Age 75 to 84 |
934 |
Number Of Beneficiaries Age Greater 84 |
732 |
Number Of Female Beneficiaries |
2008 |
Number Of Male Beneficiaries |
1617 |
Number Of Non Hispanic White Beneficiaries |
3330 |
Number Of Black or African American Beneficiaries |
179 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
2384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1241 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8543 |