National Provider Identifier [NPI]: |
1659342095 |
Last Name Of The Provider |
QUISLING |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
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 |
57 |
Number Of Services |
1616 |
Number Of Medicare Beneficiaries |
1130 |
Total Submitted Charge Amount |
540807.48 |
Total Medicare Allowed Amount |
98608.28 |
Total Medicare Payment Amount |
72472.84 |
Total Medicare Standardized Payment Amount |
73388.22 |
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 |
57 |
Number Of Medical Services |
1616 |
Number Of Medicare Beneficiaries With Medical Services |
1130 |
Total Medical Submitted Charge Amount |
540807.48 |
Total Medical Medicare Allowed Amount |
98608.28 |
Total Medical Medicare Payment Amount |
72472.84 |
Total Medical Medicare Standardized Payment Amount |
73388.22 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
308 |
Number Of Beneficiaries Age 65 to 74 |
437 |
Number Of Beneficiaries Age 75 to 84 |
276 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
614 |
Number Of Male Beneficiaries |
516 |
Number Of Non Hispanic White Beneficiaries |
926 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
724 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
406 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.9746 |