National Provider Identifier [NPI]: |
1043332711 |
Last Name Of The Provider |
MOHLINE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
CHRISTIANA HOSPITAL |
Street Address 2 Of The Provider |
4755 OGLETOWN-STANTON ROAD |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197180001 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1140 |
Number Of Medicare Beneficiaries |
627 |
Total Submitted Charge Amount |
364907 |
Total Medicare Allowed Amount |
116404.85 |
Total Medicare Payment Amount |
86013.19 |
Total Medicare Standardized Payment Amount |
88825.58 |
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 |
21 |
Number Of Medical Services |
1140 |
Number Of Medicare Beneficiaries With Medical Services |
627 |
Total Medical Submitted Charge Amount |
364907 |
Total Medical Medicare Allowed Amount |
116404.85 |
Total Medical Medicare Payment Amount |
86013.19 |
Total Medical Medicare Standardized Payment Amount |
88825.58 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
203 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
348 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
472 |
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 |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
231 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1356 |