National Provider Identifier [NPI]: |
1831276757 |
Last Name Of The Provider |
GIBLIN |
First Name Of The Provider |
WALTER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15225 SHADY GROVE RD |
Street Address 2 Of The Provider |
SUITE 303 |
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
208503234 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
7242 |
Number Of Medicare Beneficiaries |
1109 |
Total Submitted Charge Amount |
605236.94 |
Total Medicare Allowed Amount |
407330.55 |
Total Medicare Payment Amount |
297334.73 |
Total Medicare Standardized Payment Amount |
258234.05 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
480 |
Number Of Beneficiaries Age 75 to 84 |
410 |
Number Of Beneficiaries Age Greater 84 |
186 |
Number Of Female Beneficiaries |
524 |
Number Of Male Beneficiaries |
585 |
Number Of Non Hispanic White Beneficiaries |
1016 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
1061 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9432 |