National Provider Identifier [NPI]: |
1861418709 |
Last Name Of The Provider |
GUO |
First Name Of The Provider |
XIONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1578 CHARITY CHASE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTFIELD |
Zip Code Of The Provider |
460748908 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1280 |
Number Of Medicare Beneficiaries |
907 |
Total Submitted Charge Amount |
1217047 |
Total Medicare Allowed Amount |
151214.87 |
Total Medicare Payment Amount |
112639.53 |
Total Medicare Standardized Payment Amount |
117426.5 |
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 |
29 |
Number Of Medical Services |
1280 |
Number Of Medicare Beneficiaries With Medical Services |
907 |
Total Medical Submitted Charge Amount |
1217047 |
Total Medical Medicare Allowed Amount |
151214.87 |
Total Medical Medicare Payment Amount |
112639.53 |
Total Medical Medicare Standardized Payment Amount |
117426.5 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
288 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
157 |
Number Of Female Beneficiaries |
506 |
Number Of Male Beneficiaries |
401 |
Number Of Non Hispanic White Beneficiaries |
842 |
Number Of Black or African American Beneficiaries |
47 |
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 |
564 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
343 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9174 |