National Provider Identifier [NPI]: |
1306812433 |
Last Name Of The Provider |
AMBROSE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3292 STONES THROW AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
POLAND |
Zip Code Of The Provider |
44514 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
114 |
Number Of Services |
1281 |
Number Of Medicare Beneficiaries |
504 |
Total Submitted Charge Amount |
659452 |
Total Medicare Allowed Amount |
224229.96 |
Total Medicare Payment Amount |
173664.41 |
Total Medicare Standardized Payment Amount |
178538.62 |
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 |
114 |
Number Of Medical Services |
1281 |
Number Of Medicare Beneficiaries With Medical Services |
504 |
Total Medical Submitted Charge Amount |
659452 |
Total Medical Medicare Allowed Amount |
224229.96 |
Total Medical Medicare Payment Amount |
173664.41 |
Total Medical Medicare Standardized Payment Amount |
178538.62 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
259 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
461 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.926 |