National Provider Identifier [NPI]: |
1639175888 |
Last Name Of The Provider |
OSBORN |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 EMMANUEL WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
455027217 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
196 |
Number Of Services |
30611 |
Number Of Medicare Beneficiaries |
2661 |
Total Submitted Charge Amount |
1428200.7 |
Total Medicare Allowed Amount |
597729.92 |
Total Medicare Payment Amount |
468251.67 |
Total Medicare Standardized Payment Amount |
507278.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
24755 |
Number Of Medicare Beneficiaries With Drug Services |
336 |
Total Drug Submitted ChargeAmount |
33509.2 |
Total Drug Medicare AllowedAmount |
8536.13 |
Total Drug Medicare PaymentAmount |
6653.68 |
Total Drug Medicare Standardized Payment Amount |
6653.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
190 |
Number Of Medical Services |
5856 |
Number Of Medicare Beneficiaries With Medical Services |
2655 |
Total Medical Submitted Charge Amount |
1394691.5 |
Total Medical Medicare Allowed Amount |
589193.79 |
Total Medical Medicare Payment Amount |
461597.99 |
Total Medical Medicare Standardized Payment Amount |
500624.56 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
350 |
Number Of Beneficiaries Age 65 to 74 |
1159 |
Number Of Beneficiaries Age 75 to 84 |
811 |
Number Of Beneficiaries Age Greater 84 |
341 |
Number Of Female Beneficiaries |
1850 |
Number Of Male Beneficiaries |
811 |
Number Of Non Hispanic White Beneficiaries |
2499 |
Number Of Black or African American Beneficiaries |
111 |
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 |
30 |
Number Of Beneficiaries With Medicare Only Entitlement |
2234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
427 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1634 |