National Provider Identifier [NPI]: |
1326005877 |
Last Name Of The Provider |
SURDULESCU |
First Name Of The Provider |
VICTORIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7777 UNIVERSITY CT |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
WEST CHESTER |
Zip Code Of The Provider |
450696562 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
469 |
Number Of Medicare Beneficiaries |
281 |
Total Submitted Charge Amount |
191054 |
Total Medicare Allowed Amount |
51652.65 |
Total Medicare Payment Amount |
38190.7 |
Total Medicare Standardized Payment Amount |
39918.24 |
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 |
12 |
Number Of Medical Services |
469 |
Number Of Medicare Beneficiaries With Medical Services |
281 |
Total Medical Submitted Charge Amount |
191054 |
Total Medical Medicare Allowed Amount |
51652.65 |
Total Medical Medicare Payment Amount |
38190.7 |
Total Medical Medicare Standardized Payment Amount |
39918.24 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
145 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
229 |
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 |
214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5512 |