National Provider Identifier [NPI]: |
1811068067 |
Last Name Of The Provider |
ENGELHARD |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3334 CAPITAL MEDICAL BLVD |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323088405 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
867 |
Number Of Medicare Beneficiaries |
290 |
Total Submitted Charge Amount |
138873 |
Total Medicare Allowed Amount |
46338.53 |
Total Medicare Payment Amount |
35704.24 |
Total Medicare Standardized Payment Amount |
42065.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
94 |
Number Of Medicare Beneficiaries With Drug Services |
73 |
Total Drug Submitted ChargeAmount |
2217 |
Total Drug Medicare AllowedAmount |
562.98 |
Total Drug Medicare PaymentAmount |
441.15 |
Total Drug Medicare Standardized Payment Amount |
441.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
773 |
Number Of Medicare Beneficiaries With Medical Services |
290 |
Total Medical Submitted Charge Amount |
136656 |
Total Medical Medicare Allowed Amount |
45775.55 |
Total Medical Medicare Payment Amount |
35263.09 |
Total Medical Medicare Standardized Payment Amount |
41624.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
245 |
Number Of Black or African American Beneficiaries |
|
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9132 |