National Provider Identifier [NPI]: |
1750360418 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
REGINA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 BENT CREEK BLVD |
Street Address 2 Of The Provider |
SUITE 10 |
City Of The Provider |
MECHANICSBURG |
Zip Code Of The Provider |
170501869 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
485 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
51050 |
Total Medicare Allowed Amount |
35057.25 |
Total Medicare Payment Amount |
23773.67 |
Total Medicare Standardized Payment Amount |
24803.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
743 |
Total Drug Medicare AllowedAmount |
452.75 |
Total Drug Medicare PaymentAmount |
400.49 |
Total Drug Medicare Standardized Payment Amount |
400.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
462 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
50307 |
Total Medical Medicare Allowed Amount |
34604.5 |
Total Medical Medicare Payment Amount |
23373.18 |
Total Medical Medicare Standardized Payment Amount |
24402.62 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
33 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2942 |