National Provider Identifier [NPI]: |
1265492987 |
Last Name Of The Provider |
VALENTINE |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
508 S CHURCH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MT PLEASANT |
Zip Code Of The Provider |
156661702 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
1194 |
Number Of Medicare Beneficiaries |
608 |
Total Submitted Charge Amount |
457672 |
Total Medicare Allowed Amount |
108706.78 |
Total Medicare Payment Amount |
83060.43 |
Total Medicare Standardized Payment Amount |
79456.48 |
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 |
61 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
608 |
Total Medical Submitted Charge Amount |
457672 |
Total Medical Medicare Allowed Amount |
108706.78 |
Total Medical Medicare Payment Amount |
83060.43 |
Total Medical Medicare Standardized Payment Amount |
79456.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
452 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
50 |
Number Of Hispanic Beneficiaries |
64 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
360 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
248 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9993 |