National Provider Identifier [NPI]: |
1740243526 |
Last Name Of The Provider |
SELLINGER |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 CENTRE POINTE BLVD |
Street Address 2 Of The Provider |
SOUTHEASTERN UROLOGICAL CENTER PA |
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
32308 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
7274 |
Number Of Medicare Beneficiaries |
814 |
Total Submitted Charge Amount |
681980.18 |
Total Medicare Allowed Amount |
250049.35 |
Total Medicare Payment Amount |
184576.89 |
Total Medicare Standardized Payment Amount |
186420.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
4290 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
196670.84 |
Total Drug Medicare AllowedAmount |
82137.48 |
Total Drug Medicare PaymentAmount |
64198.66 |
Total Drug Medicare Standardized Payment Amount |
64198.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
82 |
Number Of Medical Services |
2984 |
Number Of Medicare Beneficiaries With Medical Services |
814 |
Total Medical Submitted Charge Amount |
485309.34 |
Total Medical Medicare Allowed Amount |
167911.87 |
Total Medical Medicare Payment Amount |
120378.23 |
Total Medical Medicare Standardized Payment Amount |
122221.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
307 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
593 |
Number Of Non Hispanic White Beneficiaries |
678 |
Number Of Black or African American Beneficiaries |
115 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
723 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1716 |