National Provider Identifier [NPI]: |
1407026479 |
Last Name Of The Provider |
EATON |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3480 WAKE FOREST RD |
Street Address 2 Of The Provider |
SUITE 506 |
City Of The Provider |
RALEIGH |
Zip Code Of The Provider |
276097376 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
741 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
434741.1 |
Total Medicare Allowed Amount |
105930.71 |
Total Medicare Payment Amount |
80334.34 |
Total Medicare Standardized Payment Amount |
83875.72 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
218 |
Number Of Black or African American Beneficiaries |
50 |
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 |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1386 |