National Provider Identifier [NPI]: |
1184940058 |
Last Name Of The Provider |
HURBAN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4092 FOXWOOD DR |
Street Address 2 Of The Provider |
ST 101 |
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234625225 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1706 |
Number Of Medicare Beneficiaries |
1088 |
Total Submitted Charge Amount |
548096 |
Total Medicare Allowed Amount |
170836.68 |
Total Medicare Payment Amount |
130183.11 |
Total Medicare Standardized Payment Amount |
132901.54 |
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 |
46 |
Number Of Medical Services |
1706 |
Number Of Medicare Beneficiaries With Medical Services |
1088 |
Total Medical Submitted Charge Amount |
548096 |
Total Medical Medicare Allowed Amount |
170836.68 |
Total Medical Medicare Payment Amount |
130183.11 |
Total Medical Medicare Standardized Payment Amount |
132901.54 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
271 |
Number Of Beneficiaries Age 65 to 74 |
330 |
Number Of Beneficiaries Age 75 to 84 |
283 |
Number Of Beneficiaries Age Greater 84 |
204 |
Number Of Female Beneficiaries |
610 |
Number Of Male Beneficiaries |
478 |
Number Of Non Hispanic White Beneficiaries |
676 |
Number Of Black or African American Beneficiaries |
372 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
787 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
301 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.1813 |