National Provider Identifier [NPI]: |
1588647085 |
Last Name Of The Provider |
PRUSSICK |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6163 EXECUTIVE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
N BETHESDA |
Zip Code Of The Provider |
208523901 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
6555 |
Number Of Medicare Beneficiaries |
1004 |
Total Submitted Charge Amount |
1082883.74 |
Total Medicare Allowed Amount |
532296.14 |
Total Medicare Payment Amount |
401926.79 |
Total Medicare Standardized Payment Amount |
365373.93 |
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 |
55 |
Number Of Medical Services |
6555 |
Number Of Medicare Beneficiaries With Medical Services |
1004 |
Total Medical Submitted Charge Amount |
1082883.74 |
Total Medical Medicare Allowed Amount |
532296.14 |
Total Medical Medicare Payment Amount |
401926.79 |
Total Medical Medicare Standardized Payment Amount |
365373.93 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
475 |
Number Of Beneficiaries Age 75 to 84 |
355 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
493 |
Number Of Male Beneficiaries |
511 |
Number Of Non Hispanic White Beneficiaries |
934 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
974 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9079 |