National Provider Identifier [NPI]: |
1679675755 |
Last Name Of The Provider |
CHECKLEY |
First Name Of The Provider |
MEGHAN |
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 |
900 S CATON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212295201 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
891 |
Number Of Medicare Beneficiaries |
773 |
Total Submitted Charge Amount |
640507 |
Total Medicare Allowed Amount |
143247.73 |
Total Medicare Payment Amount |
108942.19 |
Total Medicare Standardized Payment Amount |
103969.48 |
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 |
29 |
Number Of Medical Services |
891 |
Number Of Medicare Beneficiaries With Medical Services |
773 |
Total Medical Submitted Charge Amount |
640507 |
Total Medical Medicare Allowed Amount |
143247.73 |
Total Medical Medicare Payment Amount |
108942.19 |
Total Medical Medicare Standardized Payment Amount |
103969.48 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
299 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
421 |
Number Of Male Beneficiaries |
352 |
Number Of Non Hispanic White Beneficiaries |
210 |
Number Of Black or African American Beneficiaries |
547 |
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 |
374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
399 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.4722 |