National Provider Identifier [NPI]: |
1396780821 |
Last Name Of The Provider |
MASTER |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 SPRUCE STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
19104 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
2013 |
Number Of Medicare Beneficiaries |
979 |
Total Submitted Charge Amount |
126876 |
Total Medicare Allowed Amount |
41123.64 |
Total Medicare Payment Amount |
31540.25 |
Total Medicare Standardized Payment Amount |
29882.29 |
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 |
2013 |
Number Of Medicare Beneficiaries With Medical Services |
979 |
Total Medical Submitted Charge Amount |
126876 |
Total Medical Medicare Allowed Amount |
41123.64 |
Total Medical Medicare Payment Amount |
31540.25 |
Total Medical Medicare Standardized Payment Amount |
29882.29 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
156 |
Number Of Beneficiaries Age 65 to 74 |
484 |
Number Of Beneficiaries Age 75 to 84 |
252 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
487 |
Number Of Male Beneficiaries |
492 |
Number Of Non Hispanic White Beneficiaries |
677 |
Number Of Black or African American Beneficiaries |
235 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
841 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0031 |