National Provider Identifier [NPI]: |
1831331768 |
Last Name Of The Provider |
SELMAN |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4110 WARRENSVILLE CENTER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEACHWOOD |
Zip Code Of The Provider |
441227024 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1467 |
Number Of Medicare Beneficiaries |
467 |
Total Submitted Charge Amount |
391847 |
Total Medicare Allowed Amount |
162259.64 |
Total Medicare Payment Amount |
125933.58 |
Total Medicare Standardized Payment Amount |
130572.55 |
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 |
15 |
Number Of Medical Services |
1467 |
Number Of Medicare Beneficiaries With Medical Services |
467 |
Total Medical Submitted Charge Amount |
391847 |
Total Medical Medicare Allowed Amount |
162259.64 |
Total Medical Medicare Payment Amount |
125933.58 |
Total Medical Medicare Standardized Payment Amount |
130572.55 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
435 |
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 |
302 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.1961 |