National Provider Identifier [NPI]: |
1366480675 |
Last Name Of The Provider |
ELLSTEIN |
First Name Of The Provider |
JERRY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
166 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HUNTINGTON |
Zip Code Of The Provider |
117432948 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
147 |
Number Of Services |
6943 |
Number Of Medicare Beneficiaries |
1089 |
Total Submitted Charge Amount |
3993601.36 |
Total Medicare Allowed Amount |
519975.61 |
Total Medicare Payment Amount |
388819.58 |
Total Medicare Standardized Payment Amount |
318763.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
1213 |
Number Of Medicare Beneficiaries With Drug Services |
404 |
Total Drug Submitted ChargeAmount |
13343 |
Total Drug Medicare AllowedAmount |
6924.79 |
Total Drug Medicare PaymentAmount |
5291.29 |
Total Drug Medicare Standardized Payment Amount |
5291.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
146 |
Number Of Medical Services |
5730 |
Number Of Medicare Beneficiaries With Medical Services |
1089 |
Total Medical Submitted Charge Amount |
3980258.36 |
Total Medical Medicare Allowed Amount |
513050.82 |
Total Medical Medicare Payment Amount |
383528.29 |
Total Medical Medicare Standardized Payment Amount |
313472.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
457 |
Number Of Beneficiaries Age 75 to 84 |
388 |
Number Of Beneficiaries Age Greater 84 |
159 |
Number Of Female Beneficiaries |
682 |
Number Of Male Beneficiaries |
407 |
Number Of Non Hispanic White Beneficiaries |
1031 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1028 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0457 |