National Provider Identifier [NPI]: |
1134381759 |
Last Name Of The Provider |
BECKER |
First Name Of The Provider |
DANIELLE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 CIVIC CENTER BLVD |
Street Address 2 Of The Provider |
2ND FLOOR SOUTH PAVILLION |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191045127 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
145972 |
Total Medicare Allowed Amount |
44286.71 |
Total Medicare Payment Amount |
34497.93 |
Total Medicare Standardized Payment Amount |
32833.54 |
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 |
16 |
Number Of Medical Services |
227 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
145972 |
Total Medical Medicare Allowed Amount |
44286.71 |
Total Medical Medicare Payment Amount |
34497.93 |
Total Medical Medicare Standardized Payment Amount |
32833.54 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
70 |
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
36 |
Average HCC Risk Score Of Beneficiaries |
2.5873 |