National Provider Identifier [NPI]: |
1053631549 |
Last Name Of The Provider |
RILL |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 S FRONT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARRISBURG |
Zip Code Of The Provider |
171012010 |
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 |
24 |
Number Of Services |
1167 |
Number Of Medicare Beneficiaries |
1067 |
Total Submitted Charge Amount |
595157 |
Total Medicare Allowed Amount |
178642.96 |
Total Medicare Payment Amount |
137537.63 |
Total Medicare Standardized Payment Amount |
139602.6 |
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 |
24 |
Number Of Medical Services |
1167 |
Number Of Medicare Beneficiaries With Medical Services |
1067 |
Total Medical Submitted Charge Amount |
595157 |
Total Medical Medicare Allowed Amount |
178642.96 |
Total Medical Medicare Payment Amount |
137537.63 |
Total Medical Medicare Standardized Payment Amount |
139602.6 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
205 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
305 |
Number Of Beneficiaries Age Greater 84 |
313 |
Number Of Female Beneficiaries |
584 |
Number Of Male Beneficiaries |
483 |
Number Of Non Hispanic White Beneficiaries |
919 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
80 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
800 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
267 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.812 |