National Provider Identifier [NPI]: |
1013170695 |
Last Name Of The Provider |
O'NEILL |
First Name Of The Provider |
BRENDAN |
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 |
1255 W WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPE |
Zip Code Of The Provider |
852811210 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
639 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
68978.64 |
Total Medicare Allowed Amount |
41850.75 |
Total Medicare Payment Amount |
32585.87 |
Total Medicare Standardized Payment Amount |
26319.92 |
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 |
10 |
Number Of Medical Services |
639 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
68978.64 |
Total Medical Medicare Allowed Amount |
41850.75 |
Total Medical Medicare Payment Amount |
32585.87 |
Total Medical Medicare Standardized Payment Amount |
26319.92 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
392 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9339 |