National Provider Identifier [NPI]: |
1770512089 |
Last Name Of The Provider |
BUNNELL |
First Name Of The Provider |
EUGENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 PROSPECT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HACKENSACK |
Zip Code Of The Provider |
076011915 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
369 |
Number Of Medicare Beneficiaries |
132 |
Total Submitted Charge Amount |
119046.48 |
Total Medicare Allowed Amount |
70050.6 |
Total Medicare Payment Amount |
54346.63 |
Total Medicare Standardized Payment Amount |
50886.65 |
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 |
9 |
Number Of Medical Services |
369 |
Number Of Medicare Beneficiaries With Medical Services |
132 |
Total Medical Submitted Charge Amount |
119046.48 |
Total Medical Medicare Allowed Amount |
70050.6 |
Total Medical Medicare Payment Amount |
54346.63 |
Total Medical Medicare Standardized Payment Amount |
50886.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
100 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.7032 |