National Provider Identifier [NPI]: |
1194713289 |
Last Name Of The Provider |
NEVALA |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 WATERMAN WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAVARES |
Zip Code Of The Provider |
327785266 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
2725 |
Number Of Medicare Beneficiaries |
1444 |
Total Submitted Charge Amount |
1851195 |
Total Medicare Allowed Amount |
315456.08 |
Total Medicare Payment Amount |
244824.4 |
Total Medicare Standardized Payment Amount |
241565.17 |
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 |
34 |
Number Of Medical Services |
2725 |
Number Of Medicare Beneficiaries With Medical Services |
1444 |
Total Medical Submitted Charge Amount |
1851195 |
Total Medical Medicare Allowed Amount |
315456.08 |
Total Medical Medicare Payment Amount |
244824.4 |
Total Medical Medicare Standardized Payment Amount |
241565.17 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
266 |
Number Of Beneficiaries Age 65 to 74 |
396 |
Number Of Beneficiaries Age 75 to 84 |
443 |
Number Of Beneficiaries Age Greater 84 |
339 |
Number Of Female Beneficiaries |
845 |
Number Of Male Beneficiaries |
599 |
Number Of Non Hispanic White Beneficiaries |
1273 |
Number Of Black or African American Beneficiaries |
109 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1055 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
389 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9854 |