National Provider Identifier [NPI]: |
1154311256 |
Last Name Of The Provider |
STENBERG |
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 |
3 S 4TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARSHALLTOWN |
Zip Code Of The Provider |
501582924 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
437 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
229718 |
Total Medicare Allowed Amount |
60424.95 |
Total Medicare Payment Amount |
45276.62 |
Total Medicare Standardized Payment Amount |
47778.67 |
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 |
19 |
Number Of Medical Services |
437 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
229718 |
Total Medical Medicare Allowed Amount |
60424.95 |
Total Medical Medicare Payment Amount |
45276.62 |
Total Medical Medicare Standardized Payment Amount |
47778.67 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3449 |