National Provider Identifier [NPI]: |
1568454718 |
Last Name Of The Provider |
SULLIVAN |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2250 E MARKET ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
YORK |
Zip Code Of The Provider |
174022857 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
5351 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
327775.84 |
Total Medicare Allowed Amount |
159318.11 |
Total Medicare Payment Amount |
117272.01 |
Total Medicare Standardized Payment Amount |
122979.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
3811 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
32263.84 |
Total Drug Medicare AllowedAmount |
19169.2 |
Total Drug Medicare PaymentAmount |
14943.39 |
Total Drug Medicare Standardized Payment Amount |
14943.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
1540 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
295512 |
Total Medical Medicare Allowed Amount |
140148.91 |
Total Medical Medicare Payment Amount |
102328.62 |
Total Medical Medicare Standardized Payment Amount |
108036.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
17 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0985 |