National Provider Identifier [NPI]: |
1811080096 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
MYSHEIKA |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
240 PARSONS AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
43215 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
92 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
1477 |
Total Medicare Allowed Amount |
1359.92 |
Total Medicare Payment Amount |
1297.43 |
Total Medicare Standardized Payment Amount |
1666.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
46 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
742 |
Total Drug Medicare AllowedAmount |
661.24 |
Total Drug Medicare PaymentAmount |
648 |
Total Drug Medicare Standardized Payment Amount |
648 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
3 |
Number Of Medical Services |
46 |
Number Of Medicare Beneficiaries With Medical Services |
46 |
Total Medical Submitted Charge Amount |
735 |
Total Medical Medicare Allowed Amount |
698.68 |
Total Medical Medicare Payment Amount |
649.43 |
Total Medical Medicare Standardized Payment Amount |
1018.1 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
21 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
29 |
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 |
16 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
26 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9543 |