National Provider Identifier [NPI]: |
1972690949 |
Last Name Of The Provider |
POWELL |
First Name Of The Provider |
DOROTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4467 OLD BRANCH AVE |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
TEMPLE HILLS |
Zip Code Of The Provider |
207481854 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1531 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
70210.84 |
Total Medicare Allowed Amount |
59667.52 |
Total Medicare Payment Amount |
39924.95 |
Total Medicare Standardized Payment Amount |
38495.24 |
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 |
17 |
Number Of Medical Services |
1531 |
Number Of Medicare Beneficiaries With Medical Services |
307 |
Total Medical Submitted Charge Amount |
70210.84 |
Total Medical Medicare Allowed Amount |
59667.52 |
Total Medical Medicare Payment Amount |
39924.95 |
Total Medical Medicare Standardized Payment Amount |
38495.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
296 |
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 |
284 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
7 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4947 |