National Provider Identifier [NPI]: |
1194816314 |
Last Name Of The Provider |
GOTTRON |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 WYOMING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454092722 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
416 |
Number Of Medicare Beneficiaries |
369 |
Total Submitted Charge Amount |
157317 |
Total Medicare Allowed Amount |
58529.63 |
Total Medicare Payment Amount |
44862.19 |
Total Medicare Standardized Payment Amount |
45419.64 |
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 |
24 |
Number Of Medical Services |
416 |
Number Of Medicare Beneficiaries With Medical Services |
369 |
Total Medical Submitted Charge Amount |
157317 |
Total Medical Medicare Allowed Amount |
58529.63 |
Total Medical Medicare Payment Amount |
44862.19 |
Total Medical Medicare Standardized Payment Amount |
45419.64 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
209 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
298 |
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 |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1366 |