National Provider Identifier [NPI]: |
1053301564 |
Last Name Of The Provider |
ENTEL |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1106 DRUID RD S |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
337563846 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
221 |
Number Of Services |
5431 |
Number Of Medicare Beneficiaries |
3080 |
Total Submitted Charge Amount |
813803.4 |
Total Medicare Allowed Amount |
177745.75 |
Total Medicare Payment Amount |
137989.37 |
Total Medicare Standardized Payment Amount |
138134.56 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
474 |
Number Of Beneficiaries Age 65 to 74 |
837 |
Number Of Beneficiaries Age 75 to 84 |
998 |
Number Of Beneficiaries Age Greater 84 |
771 |
Number Of Female Beneficiaries |
1825 |
Number Of Male Beneficiaries |
1255 |
Number Of Non Hispanic White Beneficiaries |
2822 |
Number Of Black or African American Beneficiaries |
90 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
115 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
27 |
Number Of Beneficiaries With Medicare Only Entitlement |
2221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
859 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0554 |