National Provider Identifier [NPI]: |
1861432049 |
Last Name Of The Provider |
PLISCO |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD, FCCP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
621 S NEW BALLAS RD |
Street Address 2 Of The Provider |
STE 4006B |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631418232 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
631 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
289681 |
Total Medicare Allowed Amount |
106636.35 |
Total Medicare Payment Amount |
83224.85 |
Total Medicare Standardized Payment Amount |
83561.24 |
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 |
18 |
Number Of Medical Services |
631 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
289681 |
Total Medical Medicare Allowed Amount |
106636.35 |
Total Medical Medicare Payment Amount |
83224.85 |
Total Medical Medicare Standardized Payment Amount |
83561.24 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
193 |
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 |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
37 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
3.1663 |