National Provider Identifier [NPI]: |
1972766236 |
Last Name Of The Provider |
MARCHAND |
First Name Of The Provider |
ERIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
92 W CHRISTMAS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA CLAUS |
Zip Code Of The Provider |
475796044 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
199 |
Number Of Medicare Beneficiaries |
63 |
Total Submitted Charge Amount |
21676 |
Total Medicare Allowed Amount |
12177.97 |
Total Medicare Payment Amount |
9468.04 |
Total Medicare Standardized Payment Amount |
9946.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
814 |
Total Drug Medicare AllowedAmount |
258.61 |
Total Drug Medicare PaymentAmount |
249.77 |
Total Drug Medicare Standardized Payment Amount |
249.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
176 |
Number Of Medicare Beneficiaries With Medical Services |
63 |
Total Medical Submitted Charge Amount |
20862 |
Total Medical Medicare Allowed Amount |
11919.36 |
Total Medical Medicare Payment Amount |
9218.27 |
Total Medical Medicare Standardized Payment Amount |
9696.7 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
15 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
43 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
33 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1621 |