National Provider Identifier [NPI]: |
1366468621 |
Last Name Of The Provider |
RENTZ |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 RANDOLPH RD |
Street Address 2 Of The Provider |
STE 900 |
City Of The Provider |
CHARLOTTE |
Zip Code Of The Provider |
282071122 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
781 |
Number Of Medicare Beneficiaries |
481 |
Total Submitted Charge Amount |
274251 |
Total Medicare Allowed Amount |
79859.35 |
Total Medicare Payment Amount |
60247 |
Total Medicare Standardized Payment Amount |
61844.81 |
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 |
30 |
Number Of Medical Services |
781 |
Number Of Medicare Beneficiaries With Medical Services |
481 |
Total Medical Submitted Charge Amount |
274251 |
Total Medical Medicare Allowed Amount |
79859.35 |
Total Medical Medicare Payment Amount |
60247 |
Total Medical Medicare Standardized Payment Amount |
61844.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
282 |
Number Of Black or African American Beneficiaries |
175 |
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 |
320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2527 |