National Provider Identifier [NPI]: |
1790852317 |
Last Name Of The Provider |
BETTS |
First Name Of The Provider |
RONELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1805 27TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTSMOUTH |
Zip Code Of The Provider |
456622640 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
582 |
Number Of Medicare Beneficiaries |
489 |
Total Submitted Charge Amount |
302144 |
Total Medicare Allowed Amount |
48453.65 |
Total Medicare Payment Amount |
35036.06 |
Total Medicare Standardized Payment Amount |
35662.79 |
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 |
27 |
Number Of Medical Services |
582 |
Number Of Medicare Beneficiaries With Medical Services |
489 |
Total Medical Submitted Charge Amount |
302144 |
Total Medical Medicare Allowed Amount |
48453.65 |
Total Medical Medicare Payment Amount |
35036.06 |
Total Medical Medicare Standardized Payment Amount |
35662.79 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
475 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
258 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.484 |