National Provider Identifier [NPI]: |
1528065323 |
Last Name Of The Provider |
MIGHELL |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13020 N TELECOM PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TEMPLE TERRACE |
Zip Code Of The Provider |
336370925 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
6845 |
Number Of Medicare Beneficiaries |
706 |
Total Submitted Charge Amount |
1694108.9 |
Total Medicare Allowed Amount |
388774.26 |
Total Medicare Payment Amount |
289328.13 |
Total Medicare Standardized Payment Amount |
288963.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2862 |
Number Of Medicare Beneficiaries With Drug Services |
379 |
Total Drug Submitted ChargeAmount |
32880.9 |
Total Drug Medicare AllowedAmount |
13031.76 |
Total Drug Medicare PaymentAmount |
9720.23 |
Total Drug Medicare Standardized Payment Amount |
9720.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
94 |
Number Of Medical Services |
3983 |
Number Of Medicare Beneficiaries With Medical Services |
706 |
Total Medical Submitted Charge Amount |
1661228 |
Total Medical Medicare Allowed Amount |
375742.5 |
Total Medical Medicare Payment Amount |
279607.9 |
Total Medical Medicare Standardized Payment Amount |
279243.72 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
327 |
Number Of Beneficiaries Age 75 to 84 |
211 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
315 |
Number Of Non Hispanic White Beneficiaries |
567 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
78 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
620 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2383 |