National Provider Identifier [NPI]: |
1194900134 |
Last Name Of The Provider |
PETERSON |
First Name Of The Provider |
LINDSAY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
171 ASHLEY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLESTON |
Zip Code Of The Provider |
294258908 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
123305.86 |
Total Medicare Allowed Amount |
46666.71 |
Total Medicare Payment Amount |
36228.77 |
Total Medicare Standardized Payment Amount |
37954.28 |
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 |
16 |
Number Of Medical Services |
572 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
123305.86 |
Total Medical Medicare Allowed Amount |
46666.71 |
Total Medical Medicare Payment Amount |
36228.77 |
Total Medical Medicare Standardized Payment Amount |
37954.28 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
137 |
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 |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7062 |