National Provider Identifier [NPI]: |
1255390852 |
Last Name Of The Provider |
HO |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 EAST MAIN ST |
Street Address 2 Of The Provider |
STE 220 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
43215 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
4630 |
Number Of Medicare Beneficiaries |
789 |
Total Submitted Charge Amount |
800544 |
Total Medicare Allowed Amount |
299971.11 |
Total Medicare Payment Amount |
217307.98 |
Total Medicare Standardized Payment Amount |
231659.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
692 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
158936 |
Total Drug Medicare AllowedAmount |
45125.56 |
Total Drug Medicare PaymentAmount |
35064.38 |
Total Drug Medicare Standardized Payment Amount |
35064.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
3938 |
Number Of Medicare Beneficiaries With Medical Services |
789 |
Total Medical Submitted Charge Amount |
641608 |
Total Medical Medicare Allowed Amount |
254845.55 |
Total Medical Medicare Payment Amount |
182243.6 |
Total Medical Medicare Standardized Payment Amount |
196595.07 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
408 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
586 |
Number Of Non Hispanic White Beneficiaries |
703 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
15 |
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 |
701 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1191 |