National Provider Identifier [NPI]: |
1366670549 |
Last Name Of The Provider |
LE |
First Name Of The Provider |
TONY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
525 E MARKET ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AKRON |
Zip Code Of The Provider |
443041619 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
988 |
Number Of Medicare Beneficiaries |
714 |
Total Submitted Charge Amount |
401332 |
Total Medicare Allowed Amount |
104819.51 |
Total Medicare Payment Amount |
78843.75 |
Total Medicare Standardized Payment Amount |
79360.06 |
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 |
32 |
Number Of Medical Services |
988 |
Number Of Medicare Beneficiaries With Medical Services |
714 |
Total Medical Submitted Charge Amount |
401332 |
Total Medical Medicare Allowed Amount |
104819.51 |
Total Medical Medicare Payment Amount |
78843.75 |
Total Medical Medicare Standardized Payment Amount |
79360.06 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
246 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
416 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
587 |
Number Of Black or African American Beneficiaries |
107 |
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 |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
314 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0342 |