National Provider Identifier [NPI]: |
1528255064 |
Last Name Of The Provider |
EARLE-GREEN |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2776 CLEVELAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339015855 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1339 |
Number Of Medicare Beneficiaries |
866 |
Total Submitted Charge Amount |
595901 |
Total Medicare Allowed Amount |
208977.78 |
Total Medicare Payment Amount |
156341.56 |
Total Medicare Standardized Payment Amount |
150634.5 |
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 |
12 |
Number Of Medical Services |
1339 |
Number Of Medicare Beneficiaries With Medical Services |
866 |
Total Medical Submitted Charge Amount |
595901 |
Total Medical Medicare Allowed Amount |
208977.78 |
Total Medical Medicare Payment Amount |
156341.56 |
Total Medical Medicare Standardized Payment Amount |
150634.5 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
271 |
Number Of Beneficiaries Age 75 to 84 |
284 |
Number Of Beneficiaries Age Greater 84 |
190 |
Number Of Female Beneficiaries |
442 |
Number Of Male Beneficiaries |
424 |
Number Of Non Hispanic White Beneficiaries |
764 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
54 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
697 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9351 |