National Provider Identifier [NPI]: |
1720213416 |
Last Name Of The Provider |
UTHURRALT |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6410 ROCKLEDGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BETHESDA |
Zip Code Of The Provider |
208171809 |
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 |
23 |
Number Of Services |
297 |
Number Of Medicare Beneficiaries |
134 |
Total Submitted Charge Amount |
38493 |
Total Medicare Allowed Amount |
25738.99 |
Total Medicare Payment Amount |
18379.93 |
Total Medicare Standardized Payment Amount |
16470.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
688 |
Total Drug Medicare AllowedAmount |
518.14 |
Total Drug Medicare PaymentAmount |
500.73 |
Total Drug Medicare Standardized Payment Amount |
500.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
277 |
Number Of Medicare Beneficiaries With Medical Services |
134 |
Total Medical Submitted Charge Amount |
37805 |
Total Medical Medicare Allowed Amount |
25220.85 |
Total Medical Medicare Payment Amount |
17879.2 |
Total Medical Medicare Standardized Payment Amount |
15969.88 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
97 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
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 |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8994 |