Medicare Facts for Karen Doe, MS


National Provider Identifier [NPI]: 1356577761
Last Name Of The Provider DOE
First Name Of The Provider KAREN
Middle Initial Of The Provider C
Credentials Of The Provider LCSW
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 830 WASHINGTON ST
Street Address 2 Of The Provider
City Of The Provider WATERTOWN
Zip Code Of The Provider 136014034
State Code Of The Provider NY
Country Code Of The Provider US
Provider Type Of The Provider Licensed Clinical Social Worker
Medicare Participation Indicator Y
Number Of HCPCS 5
Number Of Services 322
Number Of Medicare Beneficiaries 34
Total Submitted Charge Amount 45686.96
Total Medicare Allowed Amount 20573.82
Total Medicare Payment Amount 15446.79
Total Medicare Standardized Payment Amount 15758.5
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 5
Number Of Medical Services 322
Number Of Medicare Beneficiaries With Medical Services 34
Total Medical Submitted Charge Amount 45686.96
Total Medical Medicare Allowed Amount 20573.82
Total Medical Medicare Payment Amount 15446.79
Total Medical Medicare Standardized Payment Amount 15758.5
Average Age Of Beneficiaries 59
Number Of Beneficiaries Age Less65 19
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 21
Number Of Male Beneficiaries 13
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 12
Number Of Beneficiaries With Medicare Medicaid Entitlement 22
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 75
Percent Of With Diabetes 41
Percent Of With Hyperlipidemia 62
Percent Of With Hypertension 59
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 50
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 1.5625

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