National Provider Identifier [NPI]: |
1861465809 |
Last Name Of The Provider |
EREN |
First Name Of The Provider |
ITRI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1130 TOWER BLVD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
LORAIN |
Zip Code Of The Provider |
440525235 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
2695 |
Number Of Medicare Beneficiaries |
1338 |
Total Submitted Charge Amount |
1169356.73 |
Total Medicare Allowed Amount |
287865.33 |
Total Medicare Payment Amount |
221646.38 |
Total Medicare Standardized Payment Amount |
226708.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
662.91 |
Total Drug Medicare AllowedAmount |
649.49 |
Total Drug Medicare PaymentAmount |
636.57 |
Total Drug Medicare Standardized Payment Amount |
636.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
2652 |
Number Of Medicare Beneficiaries With Medical Services |
1338 |
Total Medical Submitted Charge Amount |
1168693.82 |
Total Medical Medicare Allowed Amount |
287215.84 |
Total Medical Medicare Payment Amount |
221009.81 |
Total Medical Medicare Standardized Payment Amount |
226072.35 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
296 |
Number Of Beneficiaries Age 75 to 84 |
428 |
Number Of Beneficiaries Age Greater 84 |
449 |
Number Of Female Beneficiaries |
873 |
Number Of Male Beneficiaries |
465 |
Number Of Non Hispanic White Beneficiaries |
1196 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
773 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
565 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.349 |