National Provider Identifier [NPI]: |
1154494326 |
Last Name Of The Provider |
REZNAK |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1514 WOLF STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
19145 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
477 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
104900 |
Total Medicare Allowed Amount |
46442.32 |
Total Medicare Payment Amount |
34827.79 |
Total Medicare Standardized Payment Amount |
33656.23 |
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 |
3 |
Number Of Medical Services |
477 |
Number Of Medicare Beneficiaries With Medical Services |
288 |
Total Medical Submitted Charge Amount |
104900 |
Total Medical Medicare Allowed Amount |
46442.32 |
Total Medical Medicare Payment Amount |
34827.79 |
Total Medical Medicare Standardized Payment Amount |
33656.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
214 |
Number Of Black or African American Beneficiaries |
55 |
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
1.813 |