National Provider Identifier [NPI]: |
1821101445 |
Last Name Of The Provider |
MAGALANG |
First Name Of The Provider |
ULYSSES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2050 KENNY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432213502 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
719 |
Number Of Medicare Beneficiaries |
343 |
Total Submitted Charge Amount |
154340 |
Total Medicare Allowed Amount |
58130.57 |
Total Medicare Payment Amount |
45049.58 |
Total Medicare Standardized Payment Amount |
46173.13 |
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 |
25 |
Number Of Medical Services |
719 |
Number Of Medicare Beneficiaries With Medical Services |
343 |
Total Medical Submitted Charge Amount |
154340 |
Total Medical Medicare Allowed Amount |
58130.57 |
Total Medical Medicare Payment Amount |
45049.58 |
Total Medical Medicare Standardized Payment Amount |
46173.13 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
268 |
Number Of Black or African American Beneficiaries |
62 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2243 |