National Provider Identifier [NPI]: |
1841387891 |
Last Name Of The Provider |
BURDETTE |
First Name Of The Provider |
ALLENE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HERSHEY |
Zip Code Of The Provider |
170332360 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
986 |
Number Of Medicare Beneficiaries |
295 |
Total Submitted Charge Amount |
1156029 |
Total Medicare Allowed Amount |
111509.67 |
Total Medicare Payment Amount |
85543.66 |
Total Medicare Standardized Payment Amount |
88172.74 |
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 |
108 |
Number Of Medical Services |
986 |
Number Of Medicare Beneficiaries With Medical Services |
295 |
Total Medical Submitted Charge Amount |
1156029 |
Total Medical Medicare Allowed Amount |
111509.67 |
Total Medical Medicare Payment Amount |
85543.66 |
Total Medical Medicare Standardized Payment Amount |
88172.74 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
272 |
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 |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.7022 |