National Provider Identifier [NPI]: |
1861428492 |
Last Name Of The Provider |
HUBLER |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
530 NE GLEN OAK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616370001 |
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 |
26 |
Number Of Services |
890 |
Number Of Medicare Beneficiaries |
619 |
Total Submitted Charge Amount |
457319 |
Total Medicare Allowed Amount |
97722.12 |
Total Medicare Payment Amount |
74178.58 |
Total Medicare Standardized Payment Amount |
74503.93 |
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 |
26 |
Number Of Medical Services |
890 |
Number Of Medicare Beneficiaries With Medical Services |
619 |
Total Medical Submitted Charge Amount |
457319 |
Total Medical Medicare Allowed Amount |
97722.12 |
Total Medical Medicare Payment Amount |
74178.58 |
Total Medical Medicare Standardized Payment Amount |
74503.93 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
167 |
Number Of Female Beneficiaries |
361 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
576 |
Number Of Black or African American Beneficiaries |
22 |
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 |
487 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3594 |