National Provider Identifier [NPI]: |
1134161177 |
Last Name Of The Provider |
SCHLEIN |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 E DIXIE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEESBURG |
Zip Code Of The Provider |
347485925 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
847 |
Number Of Medicare Beneficiaries |
603 |
Total Submitted Charge Amount |
766378 |
Total Medicare Allowed Amount |
106454.75 |
Total Medicare Payment Amount |
81772.71 |
Total Medicare Standardized Payment Amount |
80664.15 |
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 |
25 |
Number Of Medical Services |
847 |
Number Of Medicare Beneficiaries With Medical Services |
603 |
Total Medical Submitted Charge Amount |
766378 |
Total Medical Medicare Allowed Amount |
106454.75 |
Total Medical Medicare Payment Amount |
81772.71 |
Total Medical Medicare Standardized Payment Amount |
80664.15 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
177 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
513 |
Number Of Black or African American Beneficiaries |
54 |
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 |
365 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9825 |