National Provider Identifier [NPI]: |
1710948914 |
Last Name Of The Provider |
O'NEIL |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
EC |
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
480736712 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
340 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
174871 |
Total Medicare Allowed Amount |
34783.73 |
Total Medicare Payment Amount |
26537.73 |
Total Medicare Standardized Payment Amount |
25593.15 |
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 |
23 |
Number Of Medical Services |
340 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
174871 |
Total Medical Medicare Allowed Amount |
34783.73 |
Total Medical Medicare Payment Amount |
26537.73 |
Total Medical Medicare Standardized Payment Amount |
25593.15 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
187 |
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
31 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
3.1711 |