National Provider Identifier [NPI]: |
1598836850 |
Last Name Of The Provider |
HILL |
First Name Of The Provider |
SHANE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
107 6TH AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
RONAN |
Zip Code Of The Provider |
598642634 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
1184 |
Number Of Medicare Beneficiaries |
356 |
Total Submitted Charge Amount |
83117.6 |
Total Medicare Allowed Amount |
44443.2 |
Total Medicare Payment Amount |
29044.43 |
Total Medicare Standardized Payment Amount |
29462.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
225 |
Number Of Medicare Beneficiaries With Drug Services |
96 |
Total Drug Submitted ChargeAmount |
2087.6 |
Total Drug Medicare AllowedAmount |
1256.34 |
Total Drug Medicare PaymentAmount |
1002.18 |
Total Drug Medicare Standardized Payment Amount |
1002.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
959 |
Number Of Medicare Beneficiaries With Medical Services |
356 |
Total Medical Submitted Charge Amount |
81030 |
Total Medical Medicare Allowed Amount |
43186.86 |
Total Medical Medicare Payment Amount |
28042.25 |
Total Medical Medicare Standardized Payment Amount |
28460.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
340 |
Number Of Black or African American Beneficiaries |
0 |
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 |
335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.808 |