National Provider Identifier [NPI]: |
1164533725 |
Last Name Of The Provider |
EMERY |
First Name Of The Provider |
DALE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
760 WICKS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
BILLINGS |
Zip Code Of The Provider |
591054427 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
863 |
Number Of Medicare Beneficiaries |
462 |
Total Submitted Charge Amount |
67553 |
Total Medicare Allowed Amount |
58446.94 |
Total Medicare Payment Amount |
34847.72 |
Total Medicare Standardized Payment Amount |
34575.74 |
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 |
863 |
Number Of Medicare Beneficiaries With Medical Services |
462 |
Total Medical Submitted Charge Amount |
67553 |
Total Medical Medicare Allowed Amount |
58446.94 |
Total Medical Medicare Payment Amount |
34847.72 |
Total Medical Medicare Standardized Payment Amount |
34575.74 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
437 |
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 |
408 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9376 |