National Provider Identifier [NPI]: |
1821105289 |
Last Name Of The Provider |
HOWARD |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 NORTH CLYDE MORRIS BLVD., SUITE 200 |
Street Address 2 Of The Provider |
HALIFAX FAMILY HEALTH CENTER |
City Of The Provider |
DAYTONA BEACH |
Zip Code Of The Provider |
321142765 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
97 |
Total Submitted Charge Amount |
37395 |
Total Medicare Allowed Amount |
24792.38 |
Total Medicare Payment Amount |
18084.96 |
Total Medicare Standardized Payment Amount |
18108.73 |
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 |
19 |
Number Of Medical Services |
227 |
Number Of Medicare Beneficiaries With Medical Services |
97 |
Total Medical Submitted Charge Amount |
37395 |
Total Medical Medicare Allowed Amount |
24792.38 |
Total Medical Medicare Payment Amount |
18084.96 |
Total Medical Medicare Standardized Payment Amount |
18108.73 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
86 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
54 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1341 |