National Provider Identifier [NPI]: |
1922025543 |
Last Name Of The Provider |
PAINTER |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 OCONNOR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTICELLO |
Zip Code Of The Provider |
479601666 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
549 |
Number Of Medicare Beneficiaries |
399 |
Total Submitted Charge Amount |
561606 |
Total Medicare Allowed Amount |
64203.86 |
Total Medicare Payment Amount |
49830.32 |
Total Medicare Standardized Payment Amount |
51938.69 |
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 |
549 |
Number Of Medicare Beneficiaries With Medical Services |
399 |
Total Medical Submitted Charge Amount |
561606 |
Total Medical Medicare Allowed Amount |
64203.86 |
Total Medical Medicare Payment Amount |
49830.32 |
Total Medical Medicare Standardized Payment Amount |
51938.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4841 |