National Provider Identifier [NPI]: |
1740246941 |
Last Name Of The Provider |
ERLIKH |
First Name Of The Provider |
TATYANA |
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 |
950A NORTH WYOMISSING BOULEVARD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYOMISSING |
Zip Code Of The Provider |
196101784 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2072 |
Number Of Medicare Beneficiaries |
363 |
Total Submitted Charge Amount |
340985 |
Total Medicare Allowed Amount |
167023.9 |
Total Medicare Payment Amount |
124198.52 |
Total Medicare Standardized Payment Amount |
130268.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
317 |
Number Of Medicare Beneficiaries With Drug Services |
205 |
Total Drug Submitted ChargeAmount |
42310 |
Total Drug Medicare AllowedAmount |
22072.09 |
Total Drug Medicare PaymentAmount |
21601.75 |
Total Drug Medicare Standardized Payment Amount |
21601.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1755 |
Number Of Medicare Beneficiaries With Medical Services |
363 |
Total Medical Submitted Charge Amount |
298675 |
Total Medical Medicare Allowed Amount |
144951.81 |
Total Medical Medicare Payment Amount |
102596.77 |
Total Medical Medicare Standardized Payment Amount |
108666.59 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
349 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
348 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1004 |