National Provider Identifier [NPI]: |
1750595112 |
Last Name Of The Provider |
CHERENFANT |
First Name Of The Provider |
JOVENEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9800 VALPARAISO DR |
Street Address 2 Of The Provider |
FRANCISCAN HAMMOND CLINIC, LLC |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463214040 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
422 |
Number Of Medicare Beneficiaries |
189 |
Total Submitted Charge Amount |
296736 |
Total Medicare Allowed Amount |
99080.26 |
Total Medicare Payment Amount |
76719.59 |
Total Medicare Standardized Payment Amount |
81050.43 |
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 |
79 |
Number Of Medical Services |
422 |
Number Of Medicare Beneficiaries With Medical Services |
189 |
Total Medical Submitted Charge Amount |
296736 |
Total Medical Medicare Allowed Amount |
99080.26 |
Total Medical Medicare Payment Amount |
76719.59 |
Total Medical Medicare Standardized Payment Amount |
81050.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
43 |
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 |
149 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.2296 |