National Provider Identifier [NPI]: |
1851596514 |
Last Name Of The Provider |
RUSK |
First Name Of The Provider |
DEBRA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 N SENATE BLVD |
Street Address 2 Of The Provider |
AG001 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
200 |
Number Of Medicare Beneficiaries |
178 |
Total Submitted Charge Amount |
55068 |
Total Medicare Allowed Amount |
23460.41 |
Total Medicare Payment Amount |
17668.96 |
Total Medicare Standardized Payment Amount |
18362.99 |
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 |
12 |
Number Of Medical Services |
200 |
Number Of Medicare Beneficiaries With Medical Services |
178 |
Total Medical Submitted Charge Amount |
55068 |
Total Medical Medicare Allowed Amount |
23460.41 |
Total Medical Medicare Payment Amount |
17668.96 |
Total Medical Medicare Standardized Payment Amount |
18362.99 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
104 |
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 |
22 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.1059 |