National Provider Identifier [NPI]: |
1497824775 |
Last Name Of The Provider |
POPOWICH |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2403 E YORK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191253005 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
194 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
18615 |
Total Medicare Allowed Amount |
16598.69 |
Total Medicare Payment Amount |
11803.88 |
Total Medicare Standardized Payment Amount |
11476.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
475 |
Total Drug Medicare AllowedAmount |
228.76 |
Total Drug Medicare PaymentAmount |
224.2 |
Total Drug Medicare Standardized Payment Amount |
224.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
6 |
Number Of Medical Services |
175 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
18140 |
Total Medical Medicare Allowed Amount |
16369.93 |
Total Medical Medicare Payment Amount |
11579.68 |
Total Medical Medicare Standardized Payment Amount |
11252.1 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
27 |
Number Of Male Beneficiaries |
42 |
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 |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
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 |
16 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
20 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0719 |