National Provider Identifier [NPI]: |
1902878135 |
Last Name Of The Provider |
REID |
First Name Of The Provider |
YVONNE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21 CROSSROADS DR |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
OWINGS MILLS |
Zip Code Of The Provider |
211175441 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
123 |
Number Of Services |
13089 |
Number Of Medicare Beneficiaries |
1587 |
Total Submitted Charge Amount |
822349.24 |
Total Medicare Allowed Amount |
175189.64 |
Total Medicare Payment Amount |
131263.19 |
Total Medicare Standardized Payment Amount |
130329.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
10631 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
13715.6 |
Total Drug Medicare AllowedAmount |
1802.07 |
Total Drug Medicare PaymentAmount |
1121.51 |
Total Drug Medicare Standardized Payment Amount |
1121.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
2458 |
Number Of Medicare Beneficiaries With Medical Services |
1587 |
Total Medical Submitted Charge Amount |
808633.64 |
Total Medical Medicare Allowed Amount |
173387.57 |
Total Medical Medicare Payment Amount |
130141.68 |
Total Medical Medicare Standardized Payment Amount |
129207.64 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
219 |
Number Of Beneficiaries Age 65 to 74 |
678 |
Number Of Beneficiaries Age 75 to 84 |
445 |
Number Of Beneficiaries Age Greater 84 |
245 |
Number Of Female Beneficiaries |
1001 |
Number Of Male Beneficiaries |
586 |
Number Of Non Hispanic White Beneficiaries |
1109 |
Number Of Black or African American Beneficiaries |
372 |
Number Of AsianPacific Islander Beneficiaries |
51 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
1259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
328 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6546 |