National Provider Identifier [NPI]: |
1487886388 |
Last Name Of The Provider |
GEORGE |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
119 OAKFIELD DR |
Street Address 2 Of The Provider |
BRANDON REGIONAL HOSPITAL EMERGENCY DEPARTMENT |
City Of The Provider |
BRANDON |
Zip Code Of The Provider |
335115779 |
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 |
31 |
Number Of Services |
732 |
Number Of Medicare Beneficiaries |
554 |
Total Submitted Charge Amount |
802279 |
Total Medicare Allowed Amount |
105024.01 |
Total Medicare Payment Amount |
80363.89 |
Total Medicare Standardized Payment Amount |
78485.7 |
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 |
31 |
Number Of Medical Services |
732 |
Number Of Medicare Beneficiaries With Medical Services |
554 |
Total Medical Submitted Charge Amount |
802279 |
Total Medical Medicare Allowed Amount |
105024.01 |
Total Medical Medicare Payment Amount |
80363.89 |
Total Medical Medicare Standardized Payment Amount |
78485.7 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
145 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
220 |
Number Of Non Hispanic White Beneficiaries |
423 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
70 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
193 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1461 |