National Provider Identifier [NPI]: |
1922118900 |
Last Name Of The Provider |
O'NEILL |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 S 7TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TERRE HAUTE |
Zip Code Of The Provider |
478025709 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
3028 |
Number Of Medicare Beneficiaries |
1123 |
Total Submitted Charge Amount |
154778.02 |
Total Medicare Allowed Amount |
108729.17 |
Total Medicare Payment Amount |
78944.36 |
Total Medicare Standardized Payment Amount |
46656.33 |
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 |
18 |
Number Of Medical Services |
3028 |
Number Of Medicare Beneficiaries With Medical Services |
1123 |
Total Medical Submitted Charge Amount |
154778.02 |
Total Medical Medicare Allowed Amount |
108729.17 |
Total Medical Medicare Payment Amount |
78944.36 |
Total Medical Medicare Standardized Payment Amount |
46656.33 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
221 |
Number Of Beneficiaries Age 65 to 74 |
523 |
Number Of Beneficiaries Age 75 to 84 |
303 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
675 |
Number Of Male Beneficiaries |
448 |
Number Of Non Hispanic White Beneficiaries |
1085 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
869 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3251 |