National Provider Identifier [NPI]: |
1417070129 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
CARA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
937 E HAVERFORD RD |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
BRYN MAWR |
Zip Code Of The Provider |
190103800 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
494 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
360668.88 |
Total Medicare Allowed Amount |
39802.88 |
Total Medicare Payment Amount |
29861.02 |
Total Medicare Standardized Payment Amount |
30315.34 |
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 |
42 |
Number Of Medical Services |
494 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
360668.88 |
Total Medical Medicare Allowed Amount |
39802.88 |
Total Medical Medicare Payment Amount |
29861.02 |
Total Medical Medicare Standardized Payment Amount |
30315.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
394 |
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 |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3244 |