National Provider Identifier [NPI]: |
1285606913 |
Last Name Of The Provider |
SARGEANT |
First Name Of The Provider |
DELWYN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5753 WAYNE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
19144 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
516 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
50441 |
Total Medicare Allowed Amount |
29074.76 |
Total Medicare Payment Amount |
18846.94 |
Total Medicare Standardized Payment Amount |
17889.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1634 |
Total Drug Medicare AllowedAmount |
933.9 |
Total Drug Medicare PaymentAmount |
915.16 |
Total Drug Medicare Standardized Payment Amount |
915.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
487 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
48807 |
Total Medical Medicare Allowed Amount |
28140.86 |
Total Medical Medicare Payment Amount |
17931.78 |
Total Medical Medicare Standardized Payment Amount |
16974.71 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
106 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3018 |