National Provider Identifier [NPI]: |
1871525105 |
Last Name Of The Provider |
SMITH-RESAR |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 N WOLFE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212870005 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
218 |
Total Submitted Charge Amount |
26042 |
Total Medicare Allowed Amount |
9916.67 |
Total Medicare Payment Amount |
7504.52 |
Total Medicare Standardized Payment Amount |
7119 |
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 |
7 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
218 |
Total Medical Submitted Charge Amount |
26042 |
Total Medical Medicare Allowed Amount |
9916.67 |
Total Medical Medicare Payment Amount |
7504.52 |
Total Medical Medicare Standardized Payment Amount |
7119 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
82 |
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.8499 |