National Provider Identifier [NPI]: |
1700881224 |
Last Name Of The Provider |
PERHALA |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36855 AMERICAN WAY |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
AVON |
Zip Code Of The Provider |
440114054 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
3927 |
Number Of Medicare Beneficiaries |
545 |
Total Submitted Charge Amount |
303888.6 |
Total Medicare Allowed Amount |
197375.65 |
Total Medicare Payment Amount |
135227.11 |
Total Medicare Standardized Payment Amount |
146131.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
1266 |
Number Of Medicare Beneficiaries With Drug Services |
184 |
Total Drug Submitted ChargeAmount |
32807.6 |
Total Drug Medicare AllowedAmount |
14635.31 |
Total Drug Medicare PaymentAmount |
11176.88 |
Total Drug Medicare Standardized Payment Amount |
11176.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
2661 |
Number Of Medicare Beneficiaries With Medical Services |
544 |
Total Medical Submitted Charge Amount |
271081 |
Total Medical Medicare Allowed Amount |
182740.34 |
Total Medical Medicare Payment Amount |
124050.23 |
Total Medical Medicare Standardized Payment Amount |
134954.89 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
132 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
392 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
488 |
Number Of Black or African American Beneficiaries |
27 |
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 |
478 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2342 |