National Provider Identifier [NPI]: |
1336198852 |
Last Name Of The Provider |
EPSTEIN |
First Name Of The Provider |
NORMAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 N WILMOT RD STE A-100 |
Street Address 2 Of The Provider |
EL DORADO INTERNAL MEDICINE |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857124416 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
176 |
Number Of Services |
3778 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
221150 |
Total Medicare Allowed Amount |
116391.06 |
Total Medicare Payment Amount |
93966.62 |
Total Medicare Standardized Payment Amount |
95478.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
557 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
12283 |
Total Drug Medicare AllowedAmount |
7967.47 |
Total Drug Medicare PaymentAmount |
7733.58 |
Total Drug Medicare Standardized Payment Amount |
7733.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
167 |
Number Of Medical Services |
3221 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
208867 |
Total Medical Medicare Allowed Amount |
108423.59 |
Total Medical Medicare Payment Amount |
86233.04 |
Total Medical Medicare Standardized Payment Amount |
87745.34 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0118 |