National Provider Identifier [NPI]: |
1548357619 |
Last Name Of The Provider |
MORALES |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
505 E 70TH ST # HT-4 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100214872 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
767 |
Number Of Medicare Beneficiaries |
282 |
Total Submitted Charge Amount |
186400 |
Total Medicare Allowed Amount |
55611.45 |
Total Medicare Payment Amount |
41888.88 |
Total Medicare Standardized Payment Amount |
38088.64 |
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 |
18 |
Number Of Medical Services |
767 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
186400 |
Total Medical Medicare Allowed Amount |
55611.45 |
Total Medical Medicare Payment Amount |
41888.88 |
Total Medical Medicare Standardized Payment Amount |
38088.64 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
114 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
106 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8554 |