National Provider Identifier [NPI]: |
1942311824 |
Last Name Of The Provider |
ROSEFF |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1429 N 6TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TERRE HAUTE |
Zip Code Of The Provider |
478071037 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
3752 |
Number Of Medicare Beneficiaries |
546 |
Total Submitted Charge Amount |
245935 |
Total Medicare Allowed Amount |
142368.33 |
Total Medicare Payment Amount |
105910.1 |
Total Medicare Standardized Payment Amount |
111760.28 |
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 |
78 |
Number Of Medical Services |
3752 |
Number Of Medicare Beneficiaries With Medical Services |
546 |
Total Medical Submitted Charge Amount |
245935 |
Total Medical Medicare Allowed Amount |
142368.33 |
Total Medical Medicare Payment Amount |
105910.1 |
Total Medical Medicare Standardized Payment Amount |
111760.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
322 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
523 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
422 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3336 |