National Provider Identifier [NPI]: |
1598083628 |
Last Name Of The Provider |
ERDMAN |
First Name Of The Provider |
VALERIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4110 WARRENSVILLE CENTER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEACHWOOD |
Zip Code Of The Provider |
441227024 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
885 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
208759 |
Total Medicare Allowed Amount |
104807.44 |
Total Medicare Payment Amount |
78787.24 |
Total Medicare Standardized Payment Amount |
80509.21 |
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 |
26 |
Number Of Medical Services |
885 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
208759 |
Total Medical Medicare Allowed Amount |
104807.44 |
Total Medical Medicare Payment Amount |
78787.24 |
Total Medical Medicare Standardized Payment Amount |
80509.21 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
133 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
442 |
Number Of Black or African American Beneficiaries |
19 |
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 |
382 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2079 |