National Provider Identifier [NPI]: |
1114182045 |
Last Name Of The Provider |
MARSH |
First Name Of The Provider |
GABRIEL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1836 SOUTH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA CROSSE |
Zip Code Of The Provider |
546015429 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
427 |
Total Submitted Charge Amount |
192332.5 |
Total Medicare Allowed Amount |
48005.16 |
Total Medicare Payment Amount |
35143.15 |
Total Medicare Standardized Payment Amount |
36600.55 |
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 |
18 |
Number Of Medical Services |
466 |
Number Of Medicare Beneficiaries With Medical Services |
427 |
Total Medical Submitted Charge Amount |
192332.5 |
Total Medical Medicare Allowed Amount |
48005.16 |
Total Medical Medicare Payment Amount |
35143.15 |
Total Medical Medicare Standardized Payment Amount |
36600.55 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
407 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.6287 |