National Provider Identifier [NPI]: |
1073618344 |
Last Name Of The Provider |
CUMBERBATCH |
First Name Of The Provider |
KARYN-ANNE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 REGIONAL MEDICAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHARTON |
Zip Code Of The Provider |
774889719 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3677 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
60745.1 |
Total Medicare Allowed Amount |
29559.85 |
Total Medicare Payment Amount |
23113.22 |
Total Medicare Standardized Payment Amount |
24825.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3003 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
1552.3 |
Total Drug Medicare AllowedAmount |
826.24 |
Total Drug Medicare PaymentAmount |
565.44 |
Total Drug Medicare Standardized Payment Amount |
565.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
674 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
59192.8 |
Total Medical Medicare Allowed Amount |
28733.61 |
Total Medical Medicare Payment Amount |
22547.78 |
Total Medical Medicare Standardized Payment Amount |
24259.94 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
38 |
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 |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8822 |