National Provider Identifier [NPI]: |
1376531046 |
Last Name Of The Provider |
CARLSON |
First Name Of The Provider |
LYNN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 COMMERCE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYOMISSING |
Zip Code Of The Provider |
196103335 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
996 |
Number Of Medicare Beneficiaries |
484 |
Total Submitted Charge Amount |
136437 |
Total Medicare Allowed Amount |
62973.83 |
Total Medicare Payment Amount |
49949.06 |
Total Medicare Standardized Payment Amount |
52493.75 |
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 |
36 |
Number Of Medical Services |
996 |
Number Of Medicare Beneficiaries With Medical Services |
484 |
Total Medical Submitted Charge Amount |
136437 |
Total Medical Medicare Allowed Amount |
62973.83 |
Total Medical Medicare Payment Amount |
49949.06 |
Total Medical Medicare Standardized Payment Amount |
52493.75 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
299 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
484 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
472 |
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 |
459 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.7724 |