National Provider Identifier [NPI]: |
1043219215 |
Last Name Of The Provider |
DEBERNARDI |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5108 HAMPTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631093113 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
6250 |
Number Of Medicare Beneficiaries |
1060 |
Total Submitted Charge Amount |
265713 |
Total Medicare Allowed Amount |
229560.88 |
Total Medicare Payment Amount |
171813.29 |
Total Medicare Standardized Payment Amount |
176705.39 |
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 |
21 |
Number Of Medical Services |
6250 |
Number Of Medicare Beneficiaries With Medical Services |
1060 |
Total Medical Submitted Charge Amount |
265713 |
Total Medical Medicare Allowed Amount |
229560.88 |
Total Medical Medicare Payment Amount |
171813.29 |
Total Medical Medicare Standardized Payment Amount |
176705.39 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
199 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
477 |
Number Of Female Beneficiaries |
714 |
Number Of Male Beneficiaries |
346 |
Number Of Non Hispanic White Beneficiaries |
926 |
Number Of Black or African American Beneficiaries |
112 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
427 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
633 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0497 |