National Provider Identifier [NPI]: |
1386655603 |
Last Name Of The Provider |
AYLESWORTH |
First Name Of The Provider |
CHERYL |
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 |
2730 UNIVERSITY BLVD W |
Street Address 2 Of The Provider |
400 |
City Of The Provider |
WHEATON |
Zip Code Of The Provider |
209021905 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
91244 |
Number Of Medicare Beneficiaries |
468 |
Total Submitted Charge Amount |
3429430 |
Total Medicare Allowed Amount |
997420.62 |
Total Medicare Payment Amount |
774439.93 |
Total Medicare Standardized Payment Amount |
753634.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
53 |
Number Of Drug Services |
87582 |
Number Of Medicare Beneficiaries With Drug Services |
96 |
Total Drug Submitted ChargeAmount |
2823324 |
Total Drug Medicare AllowedAmount |
774812.9 |
Total Drug Medicare PaymentAmount |
604458.37 |
Total Drug Medicare Standardized Payment Amount |
604458.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
3662 |
Number Of Medicare Beneficiaries With Medical Services |
468 |
Total Medical Submitted Charge Amount |
606106 |
Total Medical Medicare Allowed Amount |
222607.72 |
Total Medical Medicare Payment Amount |
169981.56 |
Total Medical Medicare Standardized Payment Amount |
149176.3 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
127 |
Number Of AsianPacific Islander Beneficiaries |
20 |
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 |
404 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
54 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7262 |