National Provider Identifier [NPI]: |
1669497913 |
Last Name Of The Provider |
OFRENEO |
First Name Of The Provider |
DANILO |
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 |
800 E CARPENTER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627690002 |
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 |
20 |
Number Of Services |
405 |
Number Of Medicare Beneficiaries |
333 |
Total Submitted Charge Amount |
289201 |
Total Medicare Allowed Amount |
55223.04 |
Total Medicare Payment Amount |
42854.59 |
Total Medicare Standardized Payment Amount |
41252.36 |
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 |
20 |
Number Of Medical Services |
405 |
Number Of Medicare Beneficiaries With Medical Services |
333 |
Total Medical Submitted Charge Amount |
289201 |
Total Medical Medicare Allowed Amount |
55223.04 |
Total Medical Medicare Payment Amount |
42854.59 |
Total Medical Medicare Standardized Payment Amount |
41252.36 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
203 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5748 |