National Provider Identifier [NPI]: |
1225321003 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5769 SALTSBURG RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
VERONA |
Zip Code Of The Provider |
151473211 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
28321 |
Total Medicare Allowed Amount |
12558.69 |
Total Medicare Payment Amount |
9883.23 |
Total Medicare Standardized Payment Amount |
10272.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
367 |
Total Drug Medicare AllowedAmount |
197.23 |
Total Drug Medicare PaymentAmount |
180.55 |
Total Drug Medicare Standardized Payment Amount |
180.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
223 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
27954 |
Total Medical Medicare Allowed Amount |
12361.46 |
Total Medical Medicare Payment Amount |
9702.68 |
Total Medical Medicare Standardized Payment Amount |
10091.7 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2187 |