National Provider Identifier [NPI]: |
1649260233 |
Last Name Of The Provider |
MAYFIELD |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2102 E INWOOD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH BEND |
Zip Code Of The Provider |
466142443 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
6818 |
Number Of Medicare Beneficiaries |
931 |
Total Submitted Charge Amount |
1610671 |
Total Medicare Allowed Amount |
657954.69 |
Total Medicare Payment Amount |
492186.41 |
Total Medicare Standardized Payment Amount |
497259.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
2936 |
Total Drug Medicare AllowedAmount |
2645.28 |
Total Drug Medicare PaymentAmount |
2073.91 |
Total Drug Medicare Standardized Payment Amount |
2073.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
6804 |
Number Of Medicare Beneficiaries With Medical Services |
931 |
Total Medical Submitted Charge Amount |
1607735 |
Total Medical Medicare Allowed Amount |
655309.41 |
Total Medical Medicare Payment Amount |
490112.5 |
Total Medical Medicare Standardized Payment Amount |
495185.49 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
359 |
Number Of Beneficiaries Age 75 to 84 |
360 |
Number Of Beneficiaries Age Greater 84 |
192 |
Number Of Female Beneficiaries |
518 |
Number Of Male Beneficiaries |
413 |
Number Of Non Hispanic White Beneficiaries |
912 |
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 |
895 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9839 |