National Provider Identifier [NPI]: |
1871508218 |
Last Name Of The Provider |
VRCELJ |
First Name Of The Provider |
VESNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12901 BRUCE B DOWNS BLVD |
Street Address 2 Of The Provider |
MDC11 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336124742 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
4042 |
Number Of Medicare Beneficiaries |
1175 |
Total Submitted Charge Amount |
845645 |
Total Medicare Allowed Amount |
151064.57 |
Total Medicare Payment Amount |
118144.64 |
Total Medicare Standardized Payment Amount |
90895.66 |
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 |
26 |
Number Of Medical Services |
4042 |
Number Of Medicare Beneficiaries With Medical Services |
1175 |
Total Medical Submitted Charge Amount |
845645 |
Total Medical Medicare Allowed Amount |
151064.57 |
Total Medical Medicare Payment Amount |
118144.64 |
Total Medical Medicare Standardized Payment Amount |
90895.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
120 |
Number Of Beneficiaries Age 65 to 74 |
538 |
Number Of Beneficiaries Age 75 to 84 |
373 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
720 |
Number Of Male Beneficiaries |
455 |
Number Of Non Hispanic White Beneficiaries |
1050 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1035 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4597 |