National Provider Identifier [NPI]: |
1407925720 |
Last Name Of The Provider |
GARRITY |
First Name Of The Provider |
PATRICK |
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 |
2300 N EDWARD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
625264163 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
919 |
Number Of Medicare Beneficiaries |
793 |
Total Submitted Charge Amount |
634586 |
Total Medicare Allowed Amount |
139220.69 |
Total Medicare Payment Amount |
101884.11 |
Total Medicare Standardized Payment Amount |
102615.96 |
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 |
22 |
Number Of Medical Services |
919 |
Number Of Medicare Beneficiaries With Medical Services |
793 |
Total Medical Submitted Charge Amount |
634586 |
Total Medical Medicare Allowed Amount |
139220.69 |
Total Medical Medicare Payment Amount |
101884.11 |
Total Medical Medicare Standardized Payment Amount |
102615.96 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
152 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
174 |
Number Of Female Beneficiaries |
445 |
Number Of Male Beneficiaries |
348 |
Number Of Non Hispanic White Beneficiaries |
677 |
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 |
536 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
257 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7865 |