National Provider Identifier [NPI]: |
1356630529 |
Last Name Of The Provider |
NEWELL |
First Name Of The Provider |
AMBER |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 PRUDENTIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322078210 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
385 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
365113 |
Total Medicare Allowed Amount |
62722.37 |
Total Medicare Payment Amount |
48740.14 |
Total Medicare Standardized Payment Amount |
48646.26 |
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 |
13 |
Number Of Medical Services |
385 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
365113 |
Total Medical Medicare Allowed Amount |
62722.37 |
Total Medical Medicare Payment Amount |
48740.14 |
Total Medical Medicare Standardized Payment Amount |
48646.26 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
258 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.098 |