National Provider Identifier [NPI]: |
1972520500 |
Last Name Of The Provider |
MCDANIEL |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
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 |
21 |
Number Of Services |
948 |
Number Of Medicare Beneficiaries |
787 |
Total Submitted Charge Amount |
686752 |
Total Medicare Allowed Amount |
135937 |
Total Medicare Payment Amount |
104566.87 |
Total Medicare Standardized Payment Amount |
105166.8 |
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 |
21 |
Number Of Medical Services |
948 |
Number Of Medicare Beneficiaries With Medical Services |
787 |
Total Medical Submitted Charge Amount |
686752 |
Total Medical Medicare Allowed Amount |
135937 |
Total Medical Medicare Payment Amount |
104566.87 |
Total Medical Medicare Standardized Payment Amount |
105166.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
187 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
329 |
Number Of Non Hispanic White Beneficiaries |
680 |
Number Of Black or African American Beneficiaries |
92 |
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 |
483 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
304 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8005 |