National Provider Identifier [NPI]: |
1679789739 |
Last Name Of The Provider |
BILLER |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
410 W 10TH AVE |
Street Address 2 Of The Provider |
N-308 DOAN HALL |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432101240 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
2645 |
Number Of Medicare Beneficiaries |
1093 |
Total Submitted Charge Amount |
205713 |
Total Medicare Allowed Amount |
60556.61 |
Total Medicare Payment Amount |
44534.97 |
Total Medicare Standardized Payment Amount |
45711 |
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 |
2645 |
Number Of Medicare Beneficiaries With Medical Services |
1093 |
Total Medical Submitted Charge Amount |
205713 |
Total Medical Medicare Allowed Amount |
60556.61 |
Total Medical Medicare Payment Amount |
44534.97 |
Total Medical Medicare Standardized Payment Amount |
45711 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
337 |
Number Of Beneficiaries Age 65 to 74 |
484 |
Number Of Beneficiaries Age 75 to 84 |
217 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
535 |
Number Of Male Beneficiaries |
558 |
Number Of Non Hispanic White Beneficiaries |
869 |
Number Of Black or African American Beneficiaries |
184 |
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 |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
765 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
328 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.5161 |