National Provider Identifier [NPI]: |
1336151786 |
Last Name Of The Provider |
BAKEWELL |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
389 S 900 E |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841022310 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
8633 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
289667 |
Total Medicare Allowed Amount |
170505.44 |
Total Medicare Payment Amount |
129732.78 |
Total Medicare Standardized Payment Amount |
131695.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
8175 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
212397 |
Total Drug Medicare AllowedAmount |
128806.39 |
Total Drug Medicare PaymentAmount |
100882.05 |
Total Drug Medicare Standardized Payment Amount |
100882.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
458 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
77270 |
Total Medical Medicare Allowed Amount |
41699.05 |
Total Medical Medicare Payment Amount |
28850.73 |
Total Medical Medicare Standardized Payment Amount |
30813.21 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
103 |
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 |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
25 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3573 |