National Provider Identifier [NPI]: |
1245363738 |
Last Name Of The Provider |
EGGERMAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3506 BOUDINOT AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452115726 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
1072 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
112699 |
Total Medicare Allowed Amount |
76912.1 |
Total Medicare Payment Amount |
51412.2 |
Total Medicare Standardized Payment Amount |
56373.08 |
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 |
8 |
Number Of Medical Services |
1072 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
112699 |
Total Medical Medicare Allowed Amount |
76912.1 |
Total Medical Medicare Payment Amount |
51412.2 |
Total Medical Medicare Standardized Payment Amount |
56373.08 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
190 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
230 |
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1942 |