National Provider Identifier [NPI]: |
1770695389 |
Last Name Of The Provider |
OSTERLUND |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 MEDICAL VILLAGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDGEWOOD |
Zip Code Of The Provider |
410173403 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
656 |
Number Of Medicare Beneficiaries |
585 |
Total Submitted Charge Amount |
149644 |
Total Medicare Allowed Amount |
84598.7 |
Total Medicare Payment Amount |
64085.87 |
Total Medicare Standardized Payment Amount |
67550.55 |
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 |
22 |
Number Of Medical Services |
656 |
Number Of Medicare Beneficiaries With Medical Services |
585 |
Total Medical Submitted Charge Amount |
149644 |
Total Medical Medicare Allowed Amount |
84598.7 |
Total Medical Medicare Payment Amount |
64085.87 |
Total Medical Medicare Standardized Payment Amount |
67550.55 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
222 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
354 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
548 |
Number Of Black or African American Beneficiaries |
|
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 |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
235 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9422 |