| National Provider Identifier [NPI]: |
1205819604 |
| Last Name Of The Provider |
MAIL |
| First Name Of The Provider |
RODNEY |
| Middle Initial Of The Provider |
W |
| Credentials Of The Provider |
MD |
| Gender Of The Provider |
M |
| Entity Type Of The Provider |
I |
| Street Address 1 Of The Provider |
2001 W 86TH ST |
| Street Address 2 Of The Provider |
|
| City Of The Provider |
INDIANAPOLIS |
| Zip Code Of The Provider |
462601902 |
| State Code Of The Provider |
IN |
| Country Code Of The Provider |
US |
| Provider Type Of The Provider |
Anesthesiology |
| Medicare Participation Indicator |
Y |
| Number Of HCPCS |
57 |
| Number Of Services |
154 |
| Number Of Medicare Beneficiaries |
141 |
| Total Submitted Charge Amount |
170519.8 |
| Total Medicare Allowed Amount |
39235.09 |
| Total Medicare Payment Amount |
30589.29 |
| Total Medicare Standardized Payment Amount |
32080.7 |
| 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 |
57 |
| Number Of Medical Services |
154 |
| Number Of Medicare Beneficiaries With Medical Services |
141 |
| Total Medical Submitted Charge Amount |
170519.8 |
| Total Medical Medicare Allowed Amount |
39235.09 |
| Total Medical Medicare Payment Amount |
30589.29 |
| Total Medical Medicare Standardized Payment Amount |
32080.7 |
| Average Age Of Beneficiaries |
70 |
| Number Of Beneficiaries Age Less65 |
33 |
| Number Of Beneficiaries Age 65 to 74 |
49 |
| Number Of Beneficiaries Age 75 to 84 |
43 |
| Number Of Beneficiaries Age Greater 84 |
16 |
| Number Of Female Beneficiaries |
86 |
| Number Of Male Beneficiaries |
55 |
| Number Of Non Hispanic White Beneficiaries |
125 |
| Number Of Black or African American Beneficiaries |
|
| Number Of AsianPacific Islander Beneficiaries |
|
| Number Of Hispanic Beneficiaries |
|
| Number Of American Indian Alaska Native Beneficiaries |
0 |
| Number Of Beneficiaries With Race Not Else where Classified |
|
| Number Of Beneficiaries With Medicare Only Entitlement |
109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
| Percent Of With Atrial Fibrillation |
14 |
| Percent Of With Alzheimers Disease or Dementia |
9 |
| Percent Of With Asthma |
12 |
| Percent Of With Cancer |
17 |
| Percent Of With Heart Failure |
24 |
| Percent Of With Chronic Kidney Disease |
35 |
| Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
| Percent Of With Depression |
35 |
| Percent Of With Diabetes |
37 |
| Percent Of With Hyperlipidemia |
57 |
| Percent Of With Hypertension |
75 |
| Percent Of With Ischemic Heart Disease |
52 |
| Percent Of With Osteoporosis |
13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
| Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
| Percent Of With Stroke |
9 |
| Average HCC Risk Score Of Beneficiaries |
1.7693 |