National Provider Identifier [NPI]: |
1407018187 |
Last Name Of The Provider |
BAZANT |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3991 DUTCHMANS LN |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402074700 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
879 |
Number Of Medicare Beneficiaries |
432 |
Total Submitted Charge Amount |
160096 |
Total Medicare Allowed Amount |
90301.84 |
Total Medicare Payment Amount |
65591.07 |
Total Medicare Standardized Payment Amount |
71110.96 |
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 |
28 |
Number Of Medical Services |
879 |
Number Of Medicare Beneficiaries With Medical Services |
432 |
Total Medical Submitted Charge Amount |
160096 |
Total Medical Medicare Allowed Amount |
90301.84 |
Total Medical Medicare Payment Amount |
65591.07 |
Total Medical Medicare Standardized Payment Amount |
71110.96 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
377 |
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 |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.5915 |