National Provider Identifier [NPI]: |
1083939276 |
Last Name Of The Provider |
HURTH |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
611 W PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
URBANA |
Zip Code Of The Provider |
618012500 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
518 |
Number Of Medicare Beneficiaries |
450 |
Total Submitted Charge Amount |
303613 |
Total Medicare Allowed Amount |
73072.87 |
Total Medicare Payment Amount |
55880.94 |
Total Medicare Standardized Payment Amount |
55782.48 |
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 |
35 |
Number Of Medical Services |
518 |
Number Of Medicare Beneficiaries With Medical Services |
450 |
Total Medical Submitted Charge Amount |
303613 |
Total Medical Medicare Allowed Amount |
73072.87 |
Total Medical Medicare Payment Amount |
55880.94 |
Total Medical Medicare Standardized Payment Amount |
55782.48 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
356 |
Number Of Black or African American Beneficiaries |
72 |
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 |
260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
190 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0693 |