National Provider Identifier [NPI]: |
1245260777 |
Last Name Of The Provider |
MARSHALL |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 S PRICE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KINGWOOD |
Zip Code Of The Provider |
265371442 |
State Code Of The Provider |
WV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
767 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
714927.96 |
Total Medicare Allowed Amount |
126950.66 |
Total Medicare Payment Amount |
98581.05 |
Total Medicare Standardized Payment Amount |
97794.77 |
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 |
90 |
Number Of Medical Services |
767 |
Number Of Medicare Beneficiaries With Medical Services |
521 |
Total Medical Submitted Charge Amount |
714927.96 |
Total Medical Medicare Allowed Amount |
126950.66 |
Total Medical Medicare Payment Amount |
98581.05 |
Total Medical Medicare Standardized Payment Amount |
97794.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
249 |
Number Of Male Beneficiaries |
272 |
Number Of Non Hispanic White Beneficiaries |
510 |
Number Of Black or African American Beneficiaries |
|
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 |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5151 |