National Provider Identifier [NPI]: |
1487605788 |
Last Name Of The Provider |
DANYLUK |
First Name Of The Provider |
TARAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 WATERS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314046220 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
880 |
Number Of Medicare Beneficiaries |
530 |
Total Submitted Charge Amount |
279477 |
Total Medicare Allowed Amount |
86641.84 |
Total Medicare Payment Amount |
66348.25 |
Total Medicare Standardized Payment Amount |
68177.26 |
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 |
31 |
Number Of Medical Services |
880 |
Number Of Medicare Beneficiaries With Medical Services |
530 |
Total Medical Submitted Charge Amount |
279477 |
Total Medical Medicare Allowed Amount |
86641.84 |
Total Medical Medicare Payment Amount |
66348.25 |
Total Medical Medicare Standardized Payment Amount |
68177.26 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
305 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
352 |
Number Of Black or African American Beneficiaries |
166 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
327 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9518 |