National Provider Identifier [NPI]: |
1760439723 |
Last Name Of The Provider |
BAND |
First Name Of The Provider |
ROGER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1020 SANSOM ST |
Street Address 2 Of The Provider |
SUITE 239 |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191075002 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
315 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
96769 |
Total Medicare Allowed Amount |
38075.76 |
Total Medicare Payment Amount |
28939.62 |
Total Medicare Standardized Payment Amount |
27668.42 |
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 |
21 |
Number Of Medical Services |
315 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
96769 |
Total Medical Medicare Allowed Amount |
38075.76 |
Total Medical Medicare Payment Amount |
28939.62 |
Total Medical Medicare Standardized Payment Amount |
27668.42 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
115 |
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 |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4576 |