National Provider Identifier [NPI]: |
1962607671 |
Last Name Of The Provider |
REID |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 SPRUCE STREET |
Street Address 2 Of The Provider |
PINE BASEMENT WEST |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
19107 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
534 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
162305 |
Total Medicare Allowed Amount |
79193.48 |
Total Medicare Payment Amount |
59608.36 |
Total Medicare Standardized Payment Amount |
55948.83 |
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 |
29 |
Number Of Medical Services |
534 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
162305 |
Total Medical Medicare Allowed Amount |
79193.48 |
Total Medical Medicare Payment Amount |
59608.36 |
Total Medical Medicare Standardized Payment Amount |
55948.83 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
179 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9712 |