National Provider Identifier [NPI]: |
1417900655 |
Last Name Of The Provider |
RAVETZ |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 LAWN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SELLERSVILLE |
Zip Code Of The Provider |
189601548 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1647 |
Number Of Medicare Beneficiaries |
468 |
Total Submitted Charge Amount |
354305 |
Total Medicare Allowed Amount |
192979.78 |
Total Medicare Payment Amount |
150597.09 |
Total Medicare Standardized Payment Amount |
138512.27 |
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 |
18 |
Number Of Medical Services |
1647 |
Number Of Medicare Beneficiaries With Medical Services |
468 |
Total Medical Submitted Charge Amount |
354305 |
Total Medical Medicare Allowed Amount |
192979.78 |
Total Medical Medicare Payment Amount |
150597.09 |
Total Medical Medicare Standardized Payment Amount |
138512.27 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
268 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
444 |
Number Of Black or African American Beneficiaries |
13 |
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 |
359 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.2196 |