National Provider Identifier [NPI]: |
1982665378 |
Last Name Of The Provider |
KERASIDIS |
First Name Of The Provider |
HARRY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 HOSPITAL RD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PRINCE FREDERICK |
Zip Code Of The Provider |
206784015 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
31467 |
Number Of Medicare Beneficiaries |
888 |
Total Submitted Charge Amount |
944251 |
Total Medicare Allowed Amount |
549996.42 |
Total Medicare Payment Amount |
398591.3 |
Total Medicare Standardized Payment Amount |
401253.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
28792 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
273162 |
Total Drug Medicare AllowedAmount |
164081.12 |
Total Drug Medicare PaymentAmount |
121692.66 |
Total Drug Medicare Standardized Payment Amount |
121692.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
2675 |
Number Of Medicare Beneficiaries With Medical Services |
888 |
Total Medical Submitted Charge Amount |
671089 |
Total Medical Medicare Allowed Amount |
385915.3 |
Total Medical Medicare Payment Amount |
276898.64 |
Total Medical Medicare Standardized Payment Amount |
279560.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
222 |
Number Of Beneficiaries Age 65 to 74 |
312 |
Number Of Beneficiaries Age 75 to 84 |
258 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
509 |
Number Of Male Beneficiaries |
379 |
Number Of Non Hispanic White Beneficiaries |
748 |
Number Of Black or African American Beneficiaries |
116 |
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 |
733 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.3534 |