National Provider Identifier [NPI]: |
1225145147 |
Last Name Of The Provider |
ROBERSON |
First Name Of The Provider |
CHERYL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2352 CREEL LANE |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
WESLEY CHAPEL |
Zip Code Of The Provider |
33544 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
447 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
65347.27 |
Total Medicare Allowed Amount |
38068.27 |
Total Medicare Payment Amount |
26055.75 |
Total Medicare Standardized Payment Amount |
27079.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
524.48 |
Total Drug Medicare AllowedAmount |
266.06 |
Total Drug Medicare PaymentAmount |
259.87 |
Total Drug Medicare Standardized Payment Amount |
259.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
423 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
64822.79 |
Total Medical Medicare Allowed Amount |
37802.21 |
Total Medical Medicare Payment Amount |
25795.88 |
Total Medical Medicare Standardized Payment Amount |
26819.37 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
73 |
Number Of Black or African American Beneficiaries |
25 |
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 |
11 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
34 |
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 |
0.8807 |