National Provider Identifier [NPI]: |
1790824704 |
Last Name Of The Provider |
SILL |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 SW RAMSEY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRANTS PASS |
Zip Code Of The Provider |
975275554 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
679 |
Number Of Medicare Beneficiaries |
555 |
Total Submitted Charge Amount |
266304.42 |
Total Medicare Allowed Amount |
88803.13 |
Total Medicare Payment Amount |
66040.17 |
Total Medicare Standardized Payment Amount |
67793.04 |
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 |
34 |
Number Of Medical Services |
679 |
Number Of Medicare Beneficiaries With Medical Services |
555 |
Total Medical Submitted Charge Amount |
266304.42 |
Total Medical Medicare Allowed Amount |
88803.13 |
Total Medical Medicare Payment Amount |
66040.17 |
Total Medical Medicare Standardized Payment Amount |
67793.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
308 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
491 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6574 |