National Provider Identifier [NPI]: |
1083723605 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 N CLYDE MORRIS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTONA BEACH |
Zip Code Of The Provider |
321142321 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
3093 |
Number Of Medicare Beneficiaries |
818 |
Total Submitted Charge Amount |
299399.79 |
Total Medicare Allowed Amount |
234126.88 |
Total Medicare Payment Amount |
175984.35 |
Total Medicare Standardized Payment Amount |
177388.61 |
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 |
21 |
Number Of Medical Services |
3093 |
Number Of Medicare Beneficiaries With Medical Services |
818 |
Total Medical Submitted Charge Amount |
299399.79 |
Total Medical Medicare Allowed Amount |
234126.88 |
Total Medical Medicare Payment Amount |
175984.35 |
Total Medical Medicare Standardized Payment Amount |
177388.61 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
257 |
Number Of Beneficiaries Age 75 to 84 |
352 |
Number Of Beneficiaries Age Greater 84 |
156 |
Number Of Female Beneficiaries |
476 |
Number Of Male Beneficiaries |
342 |
Number Of Non Hispanic White Beneficiaries |
776 |
Number Of Black or African American Beneficiaries |
23 |
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 |
746 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
73 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7427 |