National Provider Identifier [NPI]: |
1902879596 |
Last Name Of The Provider |
ERNBERG |
First Name Of The Provider |
LAUREN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
148 EAST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORWALK |
Zip Code Of The Provider |
068515721 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
133 |
Number Of Services |
2666 |
Number Of Medicare Beneficiaries |
1715 |
Total Submitted Charge Amount |
319788 |
Total Medicare Allowed Amount |
85464.57 |
Total Medicare Payment Amount |
67202.75 |
Total Medicare Standardized Payment Amount |
64201.82 |
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 |
133 |
Number Of Medical Services |
2666 |
Number Of Medicare Beneficiaries With Medical Services |
1715 |
Total Medical Submitted Charge Amount |
319788 |
Total Medical Medicare Allowed Amount |
85464.57 |
Total Medical Medicare Payment Amount |
67202.75 |
Total Medical Medicare Standardized Payment Amount |
64201.82 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
655 |
Number Of Beneficiaries Age 75 to 84 |
589 |
Number Of Beneficiaries Age Greater 84 |
321 |
Number Of Female Beneficiaries |
1254 |
Number Of Male Beneficiaries |
461 |
Number Of Non Hispanic White Beneficiaries |
1443 |
Number Of Black or African American Beneficiaries |
133 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
1346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
369 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3448 |