National Provider Identifier [NPI]: |
1033350962 |
Last Name Of The Provider |
HORNE |
First Name Of The Provider |
WESTIN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 ROBERTSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALTERBORO |
Zip Code Of The Provider |
294882787 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
736 |
Number Of Medicare Beneficiaries |
587 |
Total Submitted Charge Amount |
842905 |
Total Medicare Allowed Amount |
111321.55 |
Total Medicare Payment Amount |
85074.85 |
Total Medicare Standardized Payment Amount |
89112.38 |
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 |
25 |
Number Of Medical Services |
736 |
Number Of Medicare Beneficiaries With Medical Services |
587 |
Total Medical Submitted Charge Amount |
842905 |
Total Medical Medicare Allowed Amount |
111321.55 |
Total Medical Medicare Payment Amount |
85074.85 |
Total Medical Medicare Standardized Payment Amount |
89112.38 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
340 |
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 |
324 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
263 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1462 |