National Provider Identifier [NPI]: |
1801808423 |
Last Name Of The Provider |
FELL |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
540 THE RIALTO |
Street Address 2 Of The Provider |
|
City Of The Provider |
VENICE |
Zip Code Of The Provider |
342852900 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2633 |
Number Of Medicare Beneficiaries |
1474 |
Total Submitted Charge Amount |
955438 |
Total Medicare Allowed Amount |
272598.48 |
Total Medicare Payment Amount |
207905.15 |
Total Medicare Standardized Payment Amount |
204318.56 |
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 |
50 |
Number Of Medical Services |
2633 |
Number Of Medicare Beneficiaries With Medical Services |
1474 |
Total Medical Submitted Charge Amount |
955438 |
Total Medical Medicare Allowed Amount |
272598.48 |
Total Medical Medicare Payment Amount |
207905.15 |
Total Medical Medicare Standardized Payment Amount |
204318.56 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
386 |
Number Of Beneficiaries Age 75 to 84 |
485 |
Number Of Beneficiaries Age Greater 84 |
494 |
Number Of Female Beneficiaries |
805 |
Number Of Male Beneficiaries |
669 |
Number Of Non Hispanic White Beneficiaries |
1432 |
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 |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.742 |