National Provider Identifier [NPI]: |
1073579793 |
Last Name Of The Provider |
JUSINO |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 MICCOSUKEE RD |
Street Address 2 Of The Provider |
BIXLER EMERGENCY CENTER |
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323085054 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
687 |
Number Of Medicare Beneficiaries |
598 |
Total Submitted Charge Amount |
340345 |
Total Medicare Allowed Amount |
102547.76 |
Total Medicare Payment Amount |
77748.91 |
Total Medicare Standardized Payment Amount |
76358.99 |
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 |
32 |
Number Of Medical Services |
687 |
Number Of Medicare Beneficiaries With Medical Services |
598 |
Total Medical Submitted Charge Amount |
340345 |
Total Medical Medicare Allowed Amount |
102547.76 |
Total Medical Medicare Payment Amount |
77748.91 |
Total Medical Medicare Standardized Payment Amount |
76358.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
351 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
424 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9234 |