National Provider Identifier [NPI]: |
1922133057 |
Last Name Of The Provider |
IVKER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
375 MOUNT PLEASANT AVE |
Street Address 2 Of The Provider |
SUITE 251 |
City Of The Provider |
WEST ORANGE |
Zip Code Of The Provider |
070522724 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
10875 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
10759755 |
Total Medicare Allowed Amount |
3151385.91 |
Total Medicare Payment Amount |
2337904.5 |
Total Medicare Standardized Payment Amount |
2129259.65 |
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 |
29 |
Number Of Medical Services |
10875 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
10759755 |
Total Medical Medicare Allowed Amount |
3151385.91 |
Total Medical Medicare Payment Amount |
2337904.5 |
Total Medical Medicare Standardized Payment Amount |
2129259.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
65 |
Number Of Black or African American Beneficiaries |
82 |
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 |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
17 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3804 |