National Provider Identifier [NPI]: |
1912990508 |
Last Name Of The Provider |
EPPS |
First Name Of The Provider |
ROSELYN |
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 |
8630 FENTON STREET |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209103806 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
246 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
29768 |
Total Medicare Allowed Amount |
26774.4 |
Total Medicare Payment Amount |
20036.53 |
Total Medicare Standardized Payment Amount |
17845.44 |
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 |
24 |
Number Of Medical Services |
246 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
29768 |
Total Medical Medicare Allowed Amount |
26774.4 |
Total Medical Medicare Payment Amount |
20036.53 |
Total Medical Medicare Standardized Payment Amount |
17845.44 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
17 |
Number Of Black or African American Beneficiaries |
109 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0779 |