National Provider Identifier [NPI]: |
1639324080 |
Last Name Of The Provider |
HORN |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3401 N BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191405103 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
378 |
Number Of Medicare Beneficiaries |
251 |
Total Submitted Charge Amount |
126223 |
Total Medicare Allowed Amount |
42160.67 |
Total Medicare Payment Amount |
31469.07 |
Total Medicare Standardized Payment Amount |
30399.57 |
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 |
22 |
Number Of Medical Services |
378 |
Number Of Medicare Beneficiaries With Medical Services |
251 |
Total Medical Submitted Charge Amount |
126223 |
Total Medical Medicare Allowed Amount |
42160.67 |
Total Medical Medicare Payment Amount |
31469.07 |
Total Medical Medicare Standardized Payment Amount |
30399.57 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
86 |
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 |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2122 |