National Provider Identifier [NPI]: |
1265468417 |
Last Name Of The Provider |
GLAUN |
First Name Of The Provider |
RUSSEL |
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 |
1590 NW 10TH AVE |
Street Address 2 Of The Provider |
SUITE 304 |
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334861313 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
15616 |
Number Of Medicare Beneficiaries |
2294 |
Total Submitted Charge Amount |
1494046.43 |
Total Medicare Allowed Amount |
1020750.2 |
Total Medicare Payment Amount |
779068.45 |
Total Medicare Standardized Payment Amount |
617746.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
49 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
16958.85 |
Total Drug Medicare AllowedAmount |
11425.79 |
Total Drug Medicare PaymentAmount |
8929.1 |
Total Drug Medicare Standardized Payment Amount |
8929.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
81 |
Number Of Medical Services |
15567 |
Number Of Medicare Beneficiaries With Medical Services |
2294 |
Total Medical Submitted Charge Amount |
1477087.58 |
Total Medical Medicare Allowed Amount |
1009324.41 |
Total Medical Medicare Payment Amount |
770139.35 |
Total Medical Medicare Standardized Payment Amount |
608817.21 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
638 |
Number Of Beneficiaries Age 75 to 84 |
1006 |
Number Of Beneficiaries Age Greater 84 |
629 |
Number Of Female Beneficiaries |
1137 |
Number Of Male Beneficiaries |
1157 |
Number Of Non Hispanic White Beneficiaries |
2229 |
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 |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
2274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2558 |