National Provider Identifier [NPI]: |
1528097003 |
Last Name Of The Provider |
TORRES |
First Name Of The Provider |
ROLANDO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 W HOSPITAL RD |
Street Address 2 Of The Provider |
DEPARTMENT OF EMERGENCY MEDICINE |
City Of The Provider |
FORT GORDON |
Zip Code Of The Provider |
309055741 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
981 |
Number Of Medicare Beneficiaries |
675 |
Total Submitted Charge Amount |
770504 |
Total Medicare Allowed Amount |
114456.89 |
Total Medicare Payment Amount |
86776.87 |
Total Medicare Standardized Payment Amount |
88860.36 |
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 |
24 |
Number Of Medical Services |
981 |
Number Of Medicare Beneficiaries With Medical Services |
675 |
Total Medical Submitted Charge Amount |
770504 |
Total Medical Medicare Allowed Amount |
114456.89 |
Total Medical Medicare Payment Amount |
86776.87 |
Total Medical Medicare Standardized Payment Amount |
88860.36 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
204 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
397 |
Number Of Male Beneficiaries |
278 |
Number Of Non Hispanic White Beneficiaries |
437 |
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 |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
264 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1882 |