National Provider Identifier [NPI]: |
1619045689 |
Last Name Of The Provider |
FISHELL |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
866 SEVEN HILLS DR |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890524374 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
9785 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
1477734 |
Total Medicare Allowed Amount |
474715.21 |
Total Medicare Payment Amount |
343550.89 |
Total Medicare Standardized Payment Amount |
262764.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
6242 |
Number Of Medicare Beneficiaries With Drug Services |
288 |
Total Drug Submitted ChargeAmount |
11976 |
Total Drug Medicare AllowedAmount |
2462.1 |
Total Drug Medicare PaymentAmount |
1893.51 |
Total Drug Medicare Standardized Payment Amount |
1893.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
3543 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
1465758 |
Total Medical Medicare Allowed Amount |
472253.11 |
Total Medical Medicare Payment Amount |
341657.38 |
Total Medical Medicare Standardized Payment Amount |
260870.55 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
416 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
437 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0579 |