National Provider Identifier [NPI]: |
1467641183 |
Last Name Of The Provider |
ANIEDOBE |
First Name Of The Provider |
EDITH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 FOREST GLEN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209101483 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
746 |
Number Of Medicare Beneficiaries |
484 |
Total Submitted Charge Amount |
260998 |
Total Medicare Allowed Amount |
99756.33 |
Total Medicare Payment Amount |
76788.67 |
Total Medicare Standardized Payment Amount |
70194.26 |
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 |
14 |
Number Of Medical Services |
746 |
Number Of Medicare Beneficiaries With Medical Services |
484 |
Total Medical Submitted Charge Amount |
260998 |
Total Medical Medicare Allowed Amount |
99756.33 |
Total Medical Medicare Payment Amount |
76788.67 |
Total Medical Medicare Standardized Payment Amount |
70194.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
101 |
Number Of Black or African American Beneficiaries |
371 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.9775 |