National Provider Identifier [NPI]: |
1689629800 |
Last Name Of The Provider |
BLANDA |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
525 E MARKET ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AKRON |
Zip Code Of The Provider |
443041619 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
853 |
Number Of Medicare Beneficiaries |
553 |
Total Submitted Charge Amount |
269599.25 |
Total Medicare Allowed Amount |
88316.72 |
Total Medicare Payment Amount |
67766.43 |
Total Medicare Standardized Payment Amount |
68291.15 |
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 |
27 |
Number Of Medical Services |
853 |
Number Of Medicare Beneficiaries With Medical Services |
553 |
Total Medical Submitted Charge Amount |
269599.25 |
Total Medical Medicare Allowed Amount |
88316.72 |
Total Medical Medicare Payment Amount |
67766.43 |
Total Medical Medicare Standardized Payment Amount |
68291.15 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
210 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
411 |
Number Of Black or African American Beneficiaries |
130 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
274 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.3672 |