National Provider Identifier [NPI]: |
1407846967 |
Last Name Of The Provider |
ROZYCKI |
First Name Of The Provider |
TODD |
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 |
2102 E INWOOD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466142443 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
5782 |
Number Of Medicare Beneficiaries |
1190 |
Total Submitted Charge Amount |
1541731 |
Total Medicare Allowed Amount |
657215.31 |
Total Medicare Payment Amount |
486294.63 |
Total Medicare Standardized Payment Amount |
497460.51 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
507 |
Number Of Beneficiaries Age 75 to 84 |
428 |
Number Of Beneficiaries Age Greater 84 |
229 |
Number Of Female Beneficiaries |
529 |
Number Of Male Beneficiaries |
661 |
Number Of Non Hispanic White Beneficiaries |
1172 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9405 |