National Provider Identifier [NPI]: |
1265435978 |
Last Name Of The Provider |
PARK |
First Name Of The Provider |
AIMEE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
180 THOMAS JOHNSON DR |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
FREDERICK |
Zip Code Of The Provider |
217024409 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
4767 |
Number Of Medicare Beneficiaries |
769 |
Total Submitted Charge Amount |
889578.31 |
Total Medicare Allowed Amount |
459210.81 |
Total Medicare Payment Amount |
345477.49 |
Total Medicare Standardized Payment Amount |
343416.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
1593 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
14813.85 |
Total Drug Medicare AllowedAmount |
12914.3 |
Total Drug Medicare PaymentAmount |
9975.63 |
Total Drug Medicare Standardized Payment Amount |
9975.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
3174 |
Number Of Medicare Beneficiaries With Medical Services |
769 |
Total Medical Submitted Charge Amount |
874764.46 |
Total Medical Medicare Allowed Amount |
446296.51 |
Total Medical Medicare Payment Amount |
335501.86 |
Total Medical Medicare Standardized Payment Amount |
333441.04 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
340 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
479 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
684 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
668 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.3911 |