National Provider Identifier [NPI]: |
1154315661 |
Last Name Of The Provider |
ANGEL |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36100 EUCLID AVE |
Street Address 2 Of The Provider |
#300 |
City Of The Provider |
WILLOUGHBY |
Zip Code Of The Provider |
440944456 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1209 |
Number Of Medicare Beneficiaries |
669 |
Total Submitted Charge Amount |
858732 |
Total Medicare Allowed Amount |
117914.39 |
Total Medicare Payment Amount |
89929.55 |
Total Medicare Standardized Payment Amount |
91407.97 |
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 |
35 |
Number Of Medical Services |
1209 |
Number Of Medicare Beneficiaries With Medical Services |
669 |
Total Medical Submitted Charge Amount |
858732 |
Total Medical Medicare Allowed Amount |
117914.39 |
Total Medical Medicare Payment Amount |
89929.55 |
Total Medical Medicare Standardized Payment Amount |
91407.97 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
330 |
Number Of Male Beneficiaries |
339 |
Number Of Non Hispanic White Beneficiaries |
600 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
527 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9302 |