National Provider Identifier [NPI]: |
1063574572 |
Last Name Of The Provider |
EROSS |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7304 E DEER VALLEY RD |
Street Address 2 Of The Provider |
BLDG 1 STE 100 |
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852557459 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
11157 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
211642.77 |
Total Medicare Allowed Amount |
102512.95 |
Total Medicare Payment Amount |
76215.48 |
Total Medicare Standardized Payment Amount |
76886.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
10819 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
117773.04 |
Total Drug Medicare AllowedAmount |
58908.28 |
Total Drug Medicare PaymentAmount |
46166.75 |
Total Drug Medicare Standardized Payment Amount |
46166.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
338 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
93869.73 |
Total Medical Medicare Allowed Amount |
43604.67 |
Total Medical Medicare Payment Amount |
30048.73 |
Total Medical Medicare Standardized Payment Amount |
30719.95 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
|
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 |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
18 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
37 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0824 |