National Provider Identifier [NPI]: |
1376520585 |
Last Name Of The Provider |
WATERFIELD |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3578 FISHINGER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HILLIARD |
Zip Code Of The Provider |
430267503 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
598 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
36612.75 |
Total Medicare Allowed Amount |
20713.89 |
Total Medicare Payment Amount |
15975.33 |
Total Medicare Standardized Payment Amount |
16792.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
67 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1386 |
Total Drug Medicare AllowedAmount |
784.5 |
Total Drug Medicare PaymentAmount |
742.43 |
Total Drug Medicare Standardized Payment Amount |
742.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
531 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
35226.75 |
Total Medical Medicare Allowed Amount |
19929.39 |
Total Medical Medicare Payment Amount |
15232.9 |
Total Medical Medicare Standardized Payment Amount |
16050.37 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
31 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
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 |
|
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.759 |