National Provider Identifier [NPI]: |
1720042492 |
Last Name Of The Provider |
BRIZENDINE |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36000 EUCLID AVE |
Street Address 2 Of The Provider |
LAKE WEST HOSPITAL |
City Of The Provider |
WILLOUGHBY |
Zip Code Of The Provider |
44094 |
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 |
37 |
Number Of Services |
362 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
200260.9 |
Total Medicare Allowed Amount |
33746.53 |
Total Medicare Payment Amount |
25038.41 |
Total Medicare Standardized Payment Amount |
25390.51 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
238 |
Number Of Black or African American Beneficiaries |
19 |
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 |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4225 |