National Provider Identifier [NPI]: |
1316948508 |
Last Name Of The Provider |
ESSANDOH |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
888 BESTGATE RD |
Street Address 2 Of The Provider |
SUITE 211 |
City Of The Provider |
ANNAPOLIS |
Zip Code Of The Provider |
214013091 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
3616 |
Number Of Medicare Beneficiaries |
1278 |
Total Submitted Charge Amount |
1004836 |
Total Medicare Allowed Amount |
341894.5 |
Total Medicare Payment Amount |
259854.98 |
Total Medicare Standardized Payment Amount |
246057.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
140 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
14280 |
Total Drug Medicare AllowedAmount |
7408.98 |
Total Drug Medicare PaymentAmount |
5675.94 |
Total Drug Medicare Standardized Payment Amount |
5675.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3476 |
Number Of Medicare Beneficiaries With Medical Services |
1278 |
Total Medical Submitted Charge Amount |
990556 |
Total Medical Medicare Allowed Amount |
334485.52 |
Total Medical Medicare Payment Amount |
254179.04 |
Total Medical Medicare Standardized Payment Amount |
240381.41 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
494 |
Number Of Beneficiaries Age 75 to 84 |
440 |
Number Of Beneficiaries Age Greater 84 |
250 |
Number Of Female Beneficiaries |
645 |
Number Of Male Beneficiaries |
633 |
Number Of Non Hispanic White Beneficiaries |
952 |
Number Of Black or African American Beneficiaries |
293 |
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
1175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6315 |