National Provider Identifier [NPI]: |
1083607451 |
Last Name Of The Provider |
WAITE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 OLENTANGY RIVER RD |
Street Address 2 Of The Provider |
RMH 4 TOWER ICU |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432143908 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1192 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
410311 |
Total Medicare Allowed Amount |
139704.99 |
Total Medicare Payment Amount |
108798.48 |
Total Medicare Standardized Payment Amount |
111311.21 |
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 |
17 |
Number Of Medical Services |
1192 |
Number Of Medicare Beneficiaries With Medical Services |
347 |
Total Medical Submitted Charge Amount |
410311 |
Total Medical Medicare Allowed Amount |
139704.99 |
Total Medical Medicare Payment Amount |
108798.48 |
Total Medical Medicare Standardized Payment Amount |
111311.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
305 |
Number Of Black or African American Beneficiaries |
|
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
36 |
Average HCC Risk Score Of Beneficiaries |
2.4742 |