National Provider Identifier [NPI]: |
1487711537 |
Last Name Of The Provider |
WEISS |
First Name Of The Provider |
BURTON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 WALNUT ST |
Street Address 2 Of The Provider |
SUITE 1422 |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191022944 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
545 |
Number Of Medicare Beneficiaries |
56 |
Total Submitted Charge Amount |
69410 |
Total Medicare Allowed Amount |
38090.27 |
Total Medicare Payment Amount |
29037.19 |
Total Medicare Standardized Payment Amount |
27662.14 |
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 |
8 |
Number Of Medical Services |
545 |
Number Of Medicare Beneficiaries With Medical Services |
56 |
Total Medical Submitted Charge Amount |
69410 |
Total Medical Medicare Allowed Amount |
38090.27 |
Total Medical Medicare Payment Amount |
29037.19 |
Total Medical Medicare Standardized Payment Amount |
27662.14 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
27 |
Number Of Male Beneficiaries |
29 |
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 |
35 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
50 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
36 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3934 |