National Provider Identifier [NPI]: |
1225032592 |
Last Name Of The Provider |
LONGABAUGH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2940 N MCCORD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436151753 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2270 |
Number Of Medicare Beneficiaries |
1279 |
Total Submitted Charge Amount |
326686 |
Total Medicare Allowed Amount |
170906.21 |
Total Medicare Payment Amount |
123294.26 |
Total Medicare Standardized Payment Amount |
129310.71 |
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 |
38 |
Number Of Medical Services |
2270 |
Number Of Medicare Beneficiaries With Medical Services |
1279 |
Total Medical Submitted Charge Amount |
326686 |
Total Medical Medicare Allowed Amount |
170906.21 |
Total Medical Medicare Payment Amount |
123294.26 |
Total Medical Medicare Standardized Payment Amount |
129310.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
202 |
Number Of Beneficiaries Age 65 to 74 |
474 |
Number Of Beneficiaries Age 75 to 84 |
415 |
Number Of Beneficiaries Age Greater 84 |
188 |
Number Of Female Beneficiaries |
680 |
Number Of Male Beneficiaries |
599 |
Number Of Non Hispanic White Beneficiaries |
1177 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1058 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
221 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.632 |