National Provider Identifier [NPI]: |
1568449874 |
Last Name Of The Provider |
KETELS |
First Name Of The Provider |
ERIK |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
555 N DUKE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANCASTER |
Zip Code Of The Provider |
176022250 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
329 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
97127 |
Total Medicare Allowed Amount |
28638.38 |
Total Medicare Payment Amount |
21215.41 |
Total Medicare Standardized Payment Amount |
21523.39 |
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 |
27 |
Number Of Medical Services |
329 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
97127 |
Total Medical Medicare Allowed Amount |
28638.38 |
Total Medical Medicare Payment Amount |
21215.41 |
Total Medical Medicare Standardized Payment Amount |
21523.39 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
201 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2976 |