National Provider Identifier [NPI]: |
1457573578 |
Last Name Of The Provider |
CARROLL |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9832 YORK RD |
Street Address 2 Of The Provider |
SUITE F |
City Of The Provider |
COCKEYSVILLE |
Zip Code Of The Provider |
210304936 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
693 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
63729 |
Total Medicare Allowed Amount |
49585.74 |
Total Medicare Payment Amount |
32013.52 |
Total Medicare Standardized Payment Amount |
30607.13 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
338 |
Number Of Black or African American Beneficiaries |
11 |
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 |
298 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9262 |