National Provider Identifier [NPI]: |
1376864546 |
Last Name Of The Provider |
GENTLES |
First Name Of The Provider |
ROSELYNN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 S CLARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BUTTE |
Zip Code Of The Provider |
597012328 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
490 |
Number Of Medicare Beneficiaries |
375 |
Total Submitted Charge Amount |
157979 |
Total Medicare Allowed Amount |
58564.53 |
Total Medicare Payment Amount |
41975.76 |
Total Medicare Standardized Payment Amount |
41530.77 |
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 |
23 |
Number Of Medical Services |
490 |
Number Of Medicare Beneficiaries With Medical Services |
375 |
Total Medical Submitted Charge Amount |
157979 |
Total Medical Medicare Allowed Amount |
58564.53 |
Total Medical Medicare Payment Amount |
41975.76 |
Total Medical Medicare Standardized Payment Amount |
41530.77 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
133 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
|
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6132 |