National Provider Identifier [NPI]: |
1144266974 |
Last Name Of The Provider |
RYAN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4106 W LAKE MARY BLVD |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
LAKE MARY |
Zip Code Of The Provider |
327463315 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
11291 |
Number Of Medicare Beneficiaries |
690 |
Total Submitted Charge Amount |
508040 |
Total Medicare Allowed Amount |
388402.43 |
Total Medicare Payment Amount |
298868.75 |
Total Medicare Standardized Payment Amount |
299640.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
427 |
Number Of Medicare Beneficiaries With Drug Services |
333 |
Total Drug Submitted ChargeAmount |
10717 |
Total Drug Medicare AllowedAmount |
8496.18 |
Total Drug Medicare PaymentAmount |
8299.18 |
Total Drug Medicare Standardized Payment Amount |
8299.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
10864 |
Number Of Medicare Beneficiaries With Medical Services |
690 |
Total Medical Submitted Charge Amount |
497323 |
Total Medical Medicare Allowed Amount |
379906.25 |
Total Medical Medicare Payment Amount |
290569.57 |
Total Medical Medicare Standardized Payment Amount |
291341.57 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
273 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
369 |
Number Of Male Beneficiaries |
321 |
Number Of Non Hispanic White Beneficiaries |
647 |
Number Of Black or African American Beneficiaries |
22 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0306 |