National Provider Identifier [NPI]: |
1790714350 |
Last Name Of The Provider |
ERSCHEN |
First Name Of The Provider |
LORI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5649 WYNNEWOOD DR |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
LAURYS STATION |
Zip Code Of The Provider |
180591138 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
588 |
Number Of Medicare Beneficiaries |
206 |
Total Submitted Charge Amount |
90600 |
Total Medicare Allowed Amount |
47042.14 |
Total Medicare Payment Amount |
31317.83 |
Total Medicare Standardized Payment Amount |
33246.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
66 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
4235 |
Total Drug Medicare AllowedAmount |
3040.19 |
Total Drug Medicare PaymentAmount |
2972.7 |
Total Drug Medicare Standardized Payment Amount |
2972.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
522 |
Number Of Medicare Beneficiaries With Medical Services |
206 |
Total Medical Submitted Charge Amount |
86365 |
Total Medical Medicare Allowed Amount |
44001.95 |
Total Medical Medicare Payment Amount |
28345.13 |
Total Medical Medicare Standardized Payment Amount |
30274.03 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
59 |
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 |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8999 |