National Provider Identifier [NPI]: |
1437187952 |
Last Name Of The Provider |
DILLON |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5830 MERIDIAN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GIBSONIA |
Zip Code Of The Provider |
150449605 |
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 |
18 |
Number Of Services |
201 |
Number Of Medicare Beneficiaries |
92 |
Total Submitted Charge Amount |
35379 |
Total Medicare Allowed Amount |
17599.94 |
Total Medicare Payment Amount |
13285.31 |
Total Medicare Standardized Payment Amount |
13917.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
21 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
692 |
Total Drug Medicare AllowedAmount |
650.37 |
Total Drug Medicare PaymentAmount |
637.35 |
Total Drug Medicare Standardized Payment Amount |
637.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
180 |
Number Of Medicare Beneficiaries With Medical Services |
92 |
Total Medical Submitted Charge Amount |
34687 |
Total Medical Medicare Allowed Amount |
16949.57 |
Total Medical Medicare Payment Amount |
12647.96 |
Total Medical Medicare Standardized Payment Amount |
13280.27 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
26 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
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 |
|
Percent Of With Depression |
22 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7754 |