National Provider Identifier [NPI]: |
1972532828 |
Last Name Of The Provider |
PEIFER |
First Name Of The Provider |
MARYANNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5505 MACARTHUR RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHITEHALL |
Zip Code Of The Provider |
180521605 |
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 |
20 |
Number Of Services |
245 |
Number Of Medicare Beneficiaries |
65 |
Total Submitted Charge Amount |
37555 |
Total Medicare Allowed Amount |
19390.86 |
Total Medicare Payment Amount |
13291.01 |
Total Medicare Standardized Payment Amount |
14978.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1715 |
Total Drug Medicare AllowedAmount |
1162.07 |
Total Drug Medicare PaymentAmount |
1121.3 |
Total Drug Medicare Standardized Payment Amount |
1121.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
212 |
Number Of Medicare Beneficiaries With Medical Services |
65 |
Total Medical Submitted Charge Amount |
35840 |
Total Medical Medicare Allowed Amount |
18228.79 |
Total Medical Medicare Payment Amount |
12169.71 |
Total Medical Medicare Standardized Payment Amount |
13856.96 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
21 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0658 |