National Provider Identifier [NPI]: |
1750373841 |
Last Name Of The Provider |
BASILE |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
221 W 8TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LORAIN |
Zip Code Of The Provider |
440521817 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
1664 |
Number Of Medicare Beneficiaries |
1349 |
Total Submitted Charge Amount |
153182 |
Total Medicare Allowed Amount |
42993.39 |
Total Medicare Payment Amount |
32521.04 |
Total Medicare Standardized Payment Amount |
33513.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
1664 |
Number Of Medicare Beneficiaries With Medical Services |
1349 |
Total Medical Submitted Charge Amount |
153182 |
Total Medical Medicare Allowed Amount |
42993.39 |
Total Medical Medicare Payment Amount |
32521.04 |
Total Medical Medicare Standardized Payment Amount |
33513.06 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
312 |
Number Of Beneficiaries Age 65 to 74 |
462 |
Number Of Beneficiaries Age 75 to 84 |
364 |
Number Of Beneficiaries Age Greater 84 |
211 |
Number Of Female Beneficiaries |
808 |
Number Of Male Beneficiaries |
541 |
Number Of Non Hispanic White Beneficiaries |
1108 |
Number Of Black or African American Beneficiaries |
138 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
81 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
967 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
382 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7099 |