National Provider Identifier [NPI]: |
1467485508 |
Last Name Of The Provider |
ARP-SANDEL |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29 JONES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATHAM |
Zip Code Of The Provider |
120371136 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
313 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
21675.56 |
Total Medicare Allowed Amount |
19213.89 |
Total Medicare Payment Amount |
12489.84 |
Total Medicare Standardized Payment Amount |
12010.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
1655 |
Total Drug Medicare AllowedAmount |
1179.74 |
Total Drug Medicare PaymentAmount |
1156.16 |
Total Drug Medicare Standardized Payment Amount |
1156.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
259 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
20020.56 |
Total Medical Medicare Allowed Amount |
18034.15 |
Total Medical Medicare Payment Amount |
11333.68 |
Total Medical Medicare Standardized Payment Amount |
10854.01 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
31 |
Number Of Male Beneficiaries |
40 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
20 |
Percent Of With Hypertension |
44 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8045 |