National Provider Identifier [NPI]: |
1548284490 |
Last Name Of The Provider |
GIBBS |
First Name Of The Provider |
FRANTZ |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
593 EDDY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029034923 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
599 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
363645 |
Total Medicare Allowed Amount |
86066.62 |
Total Medicare Payment Amount |
66186.51 |
Total Medicare Standardized Payment Amount |
65149.21 |
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 |
29 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
527 |
Total Medical Submitted Charge Amount |
363645 |
Total Medical Medicare Allowed Amount |
86066.62 |
Total Medical Medicare Payment Amount |
66186.51 |
Total Medical Medicare Standardized Payment Amount |
65149.21 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
212 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
52 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
96 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
240 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9283 |