National Provider Identifier [NPI]: |
1043223860 |
Last Name Of The Provider |
BEDRICK |
First Name Of The Provider |
TRICIA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1860 STATE RD |
Street Address 2 Of The Provider |
SUITE F |
City Of The Provider |
CUYAHOGA FALLS |
Zip Code Of The Provider |
442231400 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
225 |
Number Of Medicare Beneficiaries |
58 |
Total Submitted Charge Amount |
21425 |
Total Medicare Allowed Amount |
12623.3 |
Total Medicare Payment Amount |
7809.24 |
Total Medicare Standardized Payment Amount |
8365.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
850 |
Total Drug Medicare AllowedAmount |
362.79 |
Total Drug Medicare PaymentAmount |
317.91 |
Total Drug Medicare Standardized Payment Amount |
317.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
193 |
Number Of Medicare Beneficiaries With Medical Services |
58 |
Total Medical Submitted Charge Amount |
20575 |
Total Medical Medicare Allowed Amount |
12260.51 |
Total Medical Medicare Payment Amount |
7491.33 |
Total Medical Medicare Standardized Payment Amount |
8047.76 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
11 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
43 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0566 |