National Provider Identifier [NPI]: |
1063406197 |
Last Name Of The Provider |
ROSENTHAL |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12000 MCCRACKEN RD |
Street Address 2 Of The Provider |
#453 |
City Of The Provider |
GARFIELD HEIGHTS |
Zip Code Of The Provider |
441252933 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
4701 |
Number Of Medicare Beneficiaries |
656 |
Total Submitted Charge Amount |
365122 |
Total Medicare Allowed Amount |
240246.2 |
Total Medicare Payment Amount |
184963 |
Total Medicare Standardized Payment Amount |
191677.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
501 |
Number Of Medicare Beneficiaries With Drug Services |
308 |
Total Drug Submitted ChargeAmount |
15217 |
Total Drug Medicare AllowedAmount |
6708.64 |
Total Drug Medicare PaymentAmount |
6342.39 |
Total Drug Medicare Standardized Payment Amount |
6342.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
4200 |
Number Of Medicare Beneficiaries With Medical Services |
656 |
Total Medical Submitted Charge Amount |
349905 |
Total Medical Medicare Allowed Amount |
233537.56 |
Total Medical Medicare Payment Amount |
178620.61 |
Total Medical Medicare Standardized Payment Amount |
185334.87 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
177 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
517 |
Number Of Black or African American Beneficiaries |
120 |
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 |
579 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5493 |