National Provider Identifier [NPI]: |
1851393128 |
Last Name Of The Provider |
ODONNELL |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1811 BETHLEHEM PIKE |
Street Address 2 Of The Provider |
B 232 |
City Of The Provider |
FLOURTOWN |
Zip Code Of The Provider |
190311111 |
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 |
29 |
Number Of Services |
965 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
137519 |
Total Medicare Allowed Amount |
53604.01 |
Total Medicare Payment Amount |
37949.65 |
Total Medicare Standardized Payment Amount |
36384.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
88 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
7109 |
Total Drug Medicare AllowedAmount |
2543.77 |
Total Drug Medicare PaymentAmount |
2412.41 |
Total Drug Medicare Standardized Payment Amount |
2412.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
877 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
130410 |
Total Medical Medicare Allowed Amount |
51060.24 |
Total Medical Medicare Payment Amount |
35537.24 |
Total Medical Medicare Standardized Payment Amount |
33971.64 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
180 |
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9471 |