National Provider Identifier [NPI]: |
1790726446 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
MILTON |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
222 PIEDMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452194231 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
407 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
271743 |
Total Medicare Allowed Amount |
79222.45 |
Total Medicare Payment Amount |
61555.79 |
Total Medicare Standardized Payment Amount |
62580.78 |
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 |
407 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
271743 |
Total Medical Medicare Allowed Amount |
79222.45 |
Total Medical Medicare Payment Amount |
61555.79 |
Total Medical Medicare Standardized Payment Amount |
62580.78 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
155 |
Number Of Black or African American Beneficiaries |
75 |
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 |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4418 |