National Provider Identifier [NPI]: |
1639171226 |
Last Name Of The Provider |
EGET |
First Name Of The Provider |
DONNA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1208 O'NEILL HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
DUNMORE |
Zip Code Of The Provider |
18512 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
718.5 |
Number Of Medicare Beneficiaries |
344 |
Total Submitted Charge Amount |
79002.15 |
Total Medicare Allowed Amount |
46202.56 |
Total Medicare Payment Amount |
30736.6 |
Total Medicare Standardized Payment Amount |
32587.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
92.5 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
1140.95 |
Total Drug Medicare AllowedAmount |
529.96 |
Total Drug Medicare PaymentAmount |
397.74 |
Total Drug Medicare Standardized Payment Amount |
397.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
626 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
77861.2 |
Total Medical Medicare Allowed Amount |
45672.6 |
Total Medical Medicare Payment Amount |
30338.86 |
Total Medical Medicare Standardized Payment Amount |
32189.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
297 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9186 |