National Provider Identifier [NPI]: |
1538155544 |
Last Name Of The Provider |
EMERSON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3404 W SYLVANIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436234467 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
674 |
Number Of Medicare Beneficiaries |
551 |
Total Submitted Charge Amount |
709737 |
Total Medicare Allowed Amount |
96969.09 |
Total Medicare Payment Amount |
75167.33 |
Total Medicare Standardized Payment Amount |
75602.54 |
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 |
11 |
Number Of Medical Services |
674 |
Number Of Medicare Beneficiaries With Medical Services |
551 |
Total Medical Submitted Charge Amount |
709737 |
Total Medical Medicare Allowed Amount |
96969.09 |
Total Medical Medicare Payment Amount |
75167.33 |
Total Medical Medicare Standardized Payment Amount |
75602.54 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
313 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
534 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
364 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6647 |