National Provider Identifier [NPI]: |
1497967657 |
Last Name Of The Provider |
MICHELITCH |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
629-D LOWTHER ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEWISBERRY |
Zip Code Of The Provider |
173399527 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
161 |
Number Of Services |
4033 |
Number Of Medicare Beneficiaries |
2848 |
Total Submitted Charge Amount |
490113 |
Total Medicare Allowed Amount |
128977.7 |
Total Medicare Payment Amount |
100132.6 |
Total Medicare Standardized Payment Amount |
103617.63 |
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 |
161 |
Number Of Medical Services |
4033 |
Number Of Medicare Beneficiaries With Medical Services |
2848 |
Total Medical Submitted Charge Amount |
490113 |
Total Medical Medicare Allowed Amount |
128977.7 |
Total Medical Medicare Payment Amount |
100132.6 |
Total Medical Medicare Standardized Payment Amount |
103617.63 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
417 |
Number Of Beneficiaries Age 65 to 74 |
911 |
Number Of Beneficiaries Age 75 to 84 |
913 |
Number Of Beneficiaries Age Greater 84 |
607 |
Number Of Female Beneficiaries |
1827 |
Number Of Male Beneficiaries |
1021 |
Number Of Non Hispanic White Beneficiaries |
2571 |
Number Of Black or African American Beneficiaries |
180 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
2327 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
521 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6728 |