National Provider Identifier [NPI]: |
1215044003 |
Last Name Of The Provider |
SHARE |
First Name Of The Provider |
ELLIOT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9000 FRANKLIN SQUARE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212373901 |
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 |
34 |
Number Of Services |
2731 |
Number Of Medicare Beneficiaries |
745 |
Total Submitted Charge Amount |
365535 |
Total Medicare Allowed Amount |
234892.84 |
Total Medicare Payment Amount |
167733.91 |
Total Medicare Standardized Payment Amount |
148414.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
91 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
2604 |
Total Drug Medicare AllowedAmount |
1753 |
Total Drug Medicare PaymentAmount |
1540.36 |
Total Drug Medicare Standardized Payment Amount |
1540.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2640 |
Number Of Medicare Beneficiaries With Medical Services |
745 |
Total Medical Submitted Charge Amount |
362931 |
Total Medical Medicare Allowed Amount |
233139.84 |
Total Medical Medicare Payment Amount |
166193.55 |
Total Medical Medicare Standardized Payment Amount |
146874.01 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
257 |
Number Of Beneficiaries Age Greater 84 |
356 |
Number Of Female Beneficiaries |
492 |
Number Of Male Beneficiaries |
253 |
Number Of Non Hispanic White Beneficiaries |
625 |
Number Of Black or African American Beneficiaries |
78 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
708 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4122 |