National Provider Identifier [NPI]: |
1679570048 |
Last Name Of The Provider |
PORTER |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4566 E INVERNESS AVE |
Street Address 2 Of The Provider |
STE 108 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852064633 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
2546 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
761745 |
Total Medicare Allowed Amount |
209739.74 |
Total Medicare Payment Amount |
155479.86 |
Total Medicare Standardized Payment Amount |
158816.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1292 |
Number Of Medicare Beneficiaries With Drug Services |
158 |
Total Drug Submitted ChargeAmount |
144830 |
Total Drug Medicare AllowedAmount |
62507.29 |
Total Drug Medicare PaymentAmount |
48730.96 |
Total Drug Medicare Standardized Payment Amount |
48730.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1254 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
616915 |
Total Medical Medicare Allowed Amount |
147232.45 |
Total Medical Medicare Payment Amount |
106748.9 |
Total Medical Medicare Standardized Payment Amount |
110085.54 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
245 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8255 |