National Provider Identifier [NPI]: |
1740448224 |
Last Name Of The Provider |
ESPETIA |
First Name Of The Provider |
OSCAR |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 NORTH PATTERSON STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
VALDOSTA |
Zip Code Of The Provider |
31602 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1091 |
Number Of Medicare Beneficiaries |
919 |
Total Submitted Charge Amount |
1084325 |
Total Medicare Allowed Amount |
160990.24 |
Total Medicare Payment Amount |
121376.68 |
Total Medicare Standardized Payment Amount |
123466.98 |
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 |
48 |
Number Of Medical Services |
1091 |
Number Of Medicare Beneficiaries With Medical Services |
919 |
Total Medical Submitted Charge Amount |
1084325 |
Total Medical Medicare Allowed Amount |
160990.24 |
Total Medical Medicare Payment Amount |
121376.68 |
Total Medical Medicare Standardized Payment Amount |
123466.98 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
272 |
Number Of Beneficiaries Age 65 to 74 |
308 |
Number Of Beneficiaries Age 75 to 84 |
204 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
543 |
Number Of Male Beneficiaries |
376 |
Number Of Non Hispanic White Beneficiaries |
624 |
Number Of Black or African American Beneficiaries |
272 |
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 |
521 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
398 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0374 |