National Provider Identifier [NPI]: |
1790778199 |
Last Name Of The Provider |
DZUBOW |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 CHESLEY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDIA |
Zip Code Of The Provider |
190631761 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2844 |
Number Of Medicare Beneficiaries |
834 |
Total Submitted Charge Amount |
1880270 |
Total Medicare Allowed Amount |
1220020.91 |
Total Medicare Payment Amount |
949622.39 |
Total Medicare Standardized Payment Amount |
803135.42 |
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 |
39 |
Number Of Medical Services |
2844 |
Number Of Medicare Beneficiaries With Medical Services |
834 |
Total Medical Submitted Charge Amount |
1880270 |
Total Medical Medicare Allowed Amount |
1220020.91 |
Total Medical Medicare Payment Amount |
949622.39 |
Total Medical Medicare Standardized Payment Amount |
803135.42 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
340 |
Number Of Beneficiaries Age 75 to 84 |
319 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
366 |
Number Of Male Beneficiaries |
468 |
Number Of Non Hispanic White Beneficiaries |
807 |
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 |
817 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0523 |