National Provider Identifier [NPI]: |
1093713133 |
Last Name Of The Provider |
HOLDEN |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
750 MOUNT CARMEL MALL |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432221553 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
813 |
Number Of Medicare Beneficiaries |
470 |
Total Submitted Charge Amount |
177374 |
Total Medicare Allowed Amount |
84105.28 |
Total Medicare Payment Amount |
61030.08 |
Total Medicare Standardized Payment Amount |
62547.63 |
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 |
65 |
Number Of Medical Services |
813 |
Number Of Medicare Beneficiaries With Medical Services |
470 |
Total Medical Submitted Charge Amount |
177374 |
Total Medical Medicare Allowed Amount |
84105.28 |
Total Medical Medicare Payment Amount |
61030.08 |
Total Medical Medicare Standardized Payment Amount |
62547.63 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
415 |
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 |
327 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.8621 |