National Provider Identifier [NPI]: |
1720025182 |
Last Name Of The Provider |
VITBERG |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
301 HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLEN BURNIE |
Zip Code Of The Provider |
210615803 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
875 |
Number Of Medicare Beneficiaries |
427 |
Total Submitted Charge Amount |
350475 |
Total Medicare Allowed Amount |
140897.45 |
Total Medicare Payment Amount |
109971.81 |
Total Medicare Standardized Payment Amount |
104908.13 |
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 |
33 |
Number Of Medical Services |
875 |
Number Of Medicare Beneficiaries With Medical Services |
427 |
Total Medical Submitted Charge Amount |
350475 |
Total Medical Medicare Allowed Amount |
140897.45 |
Total Medical Medicare Payment Amount |
109971.81 |
Total Medical Medicare Standardized Payment Amount |
104908.13 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
341 |
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.5931 |