National Provider Identifier [NPI]: |
1659483139 |
Last Name Of The Provider |
POTASH |
First Name Of The Provider |
PAMELA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D. O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
475 N WEABER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANNVILLE |
Zip Code Of The Provider |
170031104 |
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 |
26 |
Number Of Services |
438 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
28527 |
Total Medicare Allowed Amount |
22742.56 |
Total Medicare Payment Amount |
16852.88 |
Total Medicare Standardized Payment Amount |
17533.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
757 |
Total Drug Medicare AllowedAmount |
616.76 |
Total Drug Medicare PaymentAmount |
603.32 |
Total Drug Medicare Standardized Payment Amount |
603.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
416 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
27770 |
Total Medical Medicare Allowed Amount |
22125.8 |
Total Medical Medicare Payment Amount |
16249.56 |
Total Medical Medicare Standardized Payment Amount |
16930.41 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
29 |
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 |
47 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
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 |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1102 |