National Provider Identifier [NPI]: |
1447278577 |
Last Name Of The Provider |
RILL |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 PRUDENTIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322078202 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
565 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
458012 |
Total Medicare Allowed Amount |
87682.78 |
Total Medicare Payment Amount |
67329.62 |
Total Medicare Standardized Payment Amount |
66476.38 |
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 |
28 |
Number Of Medical Services |
565 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
458012 |
Total Medical Medicare Allowed Amount |
87682.78 |
Total Medical Medicare Payment Amount |
67329.62 |
Total Medical Medicare Standardized Payment Amount |
66476.38 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
407 |
Number Of Black or African American Beneficiaries |
60 |
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 |
332 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0245 |