National Provider Identifier [NPI]: |
1902979693 |
Last Name Of The Provider |
CSORTAN |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1350 S. HICKORY STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
32901 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
854 |
Number Of Medicare Beneficiaries |
561 |
Total Submitted Charge Amount |
485260 |
Total Medicare Allowed Amount |
107789.35 |
Total Medicare Payment Amount |
82874.48 |
Total Medicare Standardized Payment Amount |
81390.25 |
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 |
29 |
Number Of Medical Services |
854 |
Number Of Medicare Beneficiaries With Medical Services |
561 |
Total Medical Submitted Charge Amount |
485260 |
Total Medical Medicare Allowed Amount |
107789.35 |
Total Medical Medicare Payment Amount |
82874.48 |
Total Medical Medicare Standardized Payment Amount |
81390.25 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
149 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
466 |
Number Of Black or African American Beneficiaries |
61 |
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 |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2615 |