National Provider Identifier [NPI]: |
1548476393 |
Last Name Of The Provider |
KOLONDA |
First Name Of The Provider |
OMAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 EAST UNIVERSITY PARKWAY |
Street Address 2 Of The Provider |
UNION MEMORIAL HOSPITAL |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
21218 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
511 |
Number Of Medicare Beneficiaries |
467 |
Total Submitted Charge Amount |
387156 |
Total Medicare Allowed Amount |
84412.81 |
Total Medicare Payment Amount |
64573.34 |
Total Medicare Standardized Payment Amount |
61218.45 |
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 |
20 |
Number Of Medical Services |
511 |
Number Of Medicare Beneficiaries With Medical Services |
467 |
Total Medical Submitted Charge Amount |
387156 |
Total Medical Medicare Allowed Amount |
84412.81 |
Total Medical Medicare Payment Amount |
64573.34 |
Total Medical Medicare Standardized Payment Amount |
61218.45 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
248 |
Number Of Black or African American Beneficiaries |
166 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.1807 |