National Provider Identifier [NPI]: |
1992709844 |
Last Name Of The Provider |
BELL |
First Name Of The Provider |
SHAWN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
202 BEACHLEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEYERSDALE |
Zip Code Of The Provider |
155521220 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
196 |
Number Of Medicare Beneficiaries |
139 |
Total Submitted Charge Amount |
26850 |
Total Medicare Allowed Amount |
22733.36 |
Total Medicare Payment Amount |
17715.68 |
Total Medicare Standardized Payment Amount |
18052.97 |
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 |
5 |
Number Of Medical Services |
196 |
Number Of Medicare Beneficiaries With Medical Services |
139 |
Total Medical Submitted Charge Amount |
26850 |
Total Medical Medicare Allowed Amount |
22733.36 |
Total Medical Medicare Payment Amount |
17715.68 |
Total Medical Medicare Standardized Payment Amount |
18052.97 |
Average Age Of Beneficiaries |
44 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
|
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 |
18 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
32 |
Percent Of With Cancer |
0 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
60 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1178 |