National Provider Identifier [NPI]: |
1952322950 |
Last Name Of The Provider |
MCCONNELL |
First Name Of The Provider |
LILA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5530 WISCONSIN AVE |
Street Address 2 Of The Provider |
SUITE 1445 |
City Of The Provider |
CHEVY CHASE |
Zip Code Of The Provider |
20815 |
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 |
22 |
Number Of Services |
1722 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
155969 |
Total Medicare Allowed Amount |
131346.59 |
Total Medicare Payment Amount |
105685.54 |
Total Medicare Standardized Payment Amount |
95354.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
214 |
Number Of Medicare Beneficiaries With Drug Services |
178 |
Total Drug Submitted ChargeAmount |
16573 |
Total Drug Medicare AllowedAmount |
14359.7 |
Total Drug Medicare PaymentAmount |
14072.4 |
Total Drug Medicare Standardized Payment Amount |
14072.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
1508 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
139396 |
Total Medical Medicare Allowed Amount |
116986.89 |
Total Medical Medicare Payment Amount |
91613.14 |
Total Medical Medicare Standardized Payment Amount |
81281.99 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
275 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
303 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
10 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.8613 |