National Provider Identifier [NPI]: |
1558598490 |
Last Name Of The Provider |
OWENS |
First Name Of The Provider |
ERIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 N SENATE BLVD # B401 |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
686 |
Number Of Medicare Beneficiaries |
592 |
Total Submitted Charge Amount |
584482 |
Total Medicare Allowed Amount |
99553.03 |
Total Medicare Payment Amount |
75206.98 |
Total Medicare Standardized Payment Amount |
75399.42 |
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 |
686 |
Number Of Medicare Beneficiaries With Medical Services |
592 |
Total Medical Submitted Charge Amount |
584482 |
Total Medical Medicare Allowed Amount |
99553.03 |
Total Medical Medicare Payment Amount |
75206.98 |
Total Medical Medicare Standardized Payment Amount |
75399.42 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
237 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
127 |
Number Of Black or African American Beneficiaries |
349 |
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 |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
337 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
3.069 |