National Provider Identifier [NPI]: |
1225221930 |
Last Name Of The Provider |
MARGARYAN |
First Name Of The Provider |
SUSANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
169 MARTIN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EPHRATA |
Zip Code Of The Provider |
175221724 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
834 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
194436 |
Total Medicare Allowed Amount |
102809.75 |
Total Medicare Payment Amount |
80221.64 |
Total Medicare Standardized Payment Amount |
76876.88 |
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 |
17 |
Number Of Medical Services |
834 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
194436 |
Total Medical Medicare Allowed Amount |
102809.75 |
Total Medical Medicare Payment Amount |
80221.64 |
Total Medical Medicare Standardized Payment Amount |
76876.88 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
315 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
288 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1126 |