National Provider Identifier [NPI]: |
1003875915 |
Last Name Of The Provider |
CANCELL |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
456 S BROADWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLOUCESTER CITY |
Zip Code Of The Provider |
080302343 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
3104 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
276693 |
Total Medicare Allowed Amount |
177030.72 |
Total Medicare Payment Amount |
126241.24 |
Total Medicare Standardized Payment Amount |
116628.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
146 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
1542 |
Total Drug Medicare AllowedAmount |
255.35 |
Total Drug Medicare PaymentAmount |
179.74 |
Total Drug Medicare Standardized Payment Amount |
179.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
2958 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
275151 |
Total Medical Medicare Allowed Amount |
176775.37 |
Total Medical Medicare Payment Amount |
126061.5 |
Total Medical Medicare Standardized Payment Amount |
116449.19 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
188 |
Number Of Non Hispanic White Beneficiaries |
438 |
Number Of Black or African American Beneficiaries |
30 |
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 |
430 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2449 |