National Provider Identifier [NPI]: |
1215917018 |
Last Name Of The Provider |
CUNNINGHAM |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 NE 25TH AVE |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344705667 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
2687 |
Number Of Medicare Beneficiaries |
711 |
Total Submitted Charge Amount |
263267 |
Total Medicare Allowed Amount |
111683.89 |
Total Medicare Payment Amount |
78874.69 |
Total Medicare Standardized Payment Amount |
79346.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
409 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
4078 |
Total Drug Medicare AllowedAmount |
1141.5 |
Total Drug Medicare PaymentAmount |
869.47 |
Total Drug Medicare Standardized Payment Amount |
869.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
2278 |
Number Of Medicare Beneficiaries With Medical Services |
711 |
Total Medical Submitted Charge Amount |
259189 |
Total Medical Medicare Allowed Amount |
110542.39 |
Total Medical Medicare Payment Amount |
78005.22 |
Total Medical Medicare Standardized Payment Amount |
78476.72 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
299 |
Number Of Beneficiaries Age 75 to 84 |
249 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
434 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
681 |
Number Of Black or African American Beneficiaries |
14 |
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 |
651 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1262 |