National Provider Identifier [NPI]: |
1073773875 |
Last Name Of The Provider |
DEVLIN |
First Name Of The Provider |
COURTNEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 S FRONT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARRISBURG |
Zip Code Of The Provider |
171012010 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
670 |
Number Of Medicare Beneficiaries |
579 |
Total Submitted Charge Amount |
622441 |
Total Medicare Allowed Amount |
103461.3 |
Total Medicare Payment Amount |
76942.55 |
Total Medicare Standardized Payment Amount |
78982.63 |
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 |
26 |
Number Of Medical Services |
670 |
Number Of Medicare Beneficiaries With Medical Services |
579 |
Total Medical Submitted Charge Amount |
622441 |
Total Medical Medicare Allowed Amount |
103461.3 |
Total Medical Medicare Payment Amount |
76942.55 |
Total Medical Medicare Standardized Payment Amount |
78982.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
335 |
Number Of Male Beneficiaries |
244 |
Number Of Non Hispanic White Beneficiaries |
358 |
Number Of Black or African American Beneficiaries |
204 |
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 |
344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
235 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0594 |