National Provider Identifier [NPI]: |
1881921534 |
Last Name Of The Provider |
POLDERMAN |
First Name Of The Provider |
KEES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3550 TERRACE STREET |
Street Address 2 Of The Provider |
6TH FL SCAIFE HALL |
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
15261 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
404168 |
Total Medicare Allowed Amount |
130562.44 |
Total Medicare Payment Amount |
101506.59 |
Total Medicare Standardized Payment Amount |
103882.86 |
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 |
17 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
404168 |
Total Medical Medicare Allowed Amount |
130562.44 |
Total Medical Medicare Payment Amount |
101506.59 |
Total Medical Medicare Standardized Payment Amount |
103882.86 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
207 |
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
61 |
Average HCC Risk Score Of Beneficiaries |
1.9031 |