National Provider Identifier [NPI]: |
1679575690 |
Last Name Of The Provider |
SCHOTT |
First Name Of The Provider |
JON |
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 |
1 MEDICAL VILLAGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDGEWOOD |
Zip Code Of The Provider |
410173403 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
717 |
Number Of Medicare Beneficiaries |
639 |
Total Submitted Charge Amount |
162898 |
Total Medicare Allowed Amount |
92223.81 |
Total Medicare Payment Amount |
70228.1 |
Total Medicare Standardized Payment Amount |
73468.12 |
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 |
21 |
Number Of Medical Services |
717 |
Number Of Medicare Beneficiaries With Medical Services |
639 |
Total Medical Submitted Charge Amount |
162898 |
Total Medical Medicare Allowed Amount |
92223.81 |
Total Medical Medicare Payment Amount |
70228.1 |
Total Medical Medicare Standardized Payment Amount |
73468.12 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
272 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
362 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
587 |
Number Of Black or African American Beneficiaries |
39 |
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 |
360 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
279 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8253 |