National Provider Identifier [NPI]: |
1629019948 |
Last Name Of The Provider |
BECK |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5051 GREENSPRING AVE |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212094354 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
113 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
18430 |
Total Medicare Allowed Amount |
9617.51 |
Total Medicare Payment Amount |
7360.83 |
Total Medicare Standardized Payment Amount |
8144.94 |
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 |
16 |
Number Of Medical Services |
113 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
18430 |
Total Medical Medicare Allowed Amount |
9617.51 |
Total Medical Medicare Payment Amount |
7360.83 |
Total Medical Medicare Standardized Payment Amount |
8144.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
60 |
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
|
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4472 |