National Provider Identifier [NPI]: |
1295753218 |
Last Name Of The Provider |
GILROY |
First Name Of The Provider |
RONALD |
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 |
1350 S HICKORY STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
32901 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1519 |
Number Of Medicare Beneficiaries |
938 |
Total Submitted Charge Amount |
812909 |
Total Medicare Allowed Amount |
179555.18 |
Total Medicare Payment Amount |
138811.92 |
Total Medicare Standardized Payment Amount |
136518.57 |
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 |
19 |
Number Of Medical Services |
1519 |
Number Of Medicare Beneficiaries With Medical Services |
938 |
Total Medical Submitted Charge Amount |
812909 |
Total Medical Medicare Allowed Amount |
179555.18 |
Total Medical Medicare Payment Amount |
138811.92 |
Total Medical Medicare Standardized Payment Amount |
136518.57 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
319 |
Number Of Beneficiaries Age Greater 84 |
224 |
Number Of Female Beneficiaries |
556 |
Number Of Male Beneficiaries |
382 |
Number Of Non Hispanic White Beneficiaries |
776 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
691 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
247 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0913 |