National Provider Identifier [NPI]: |
1609018274 |
Last Name Of The Provider |
SCHELL |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 BRYAN ST |
Street Address 2 Of The Provider |
SUITE 7 |
City Of The Provider |
HUNTINGDON |
Zip Code Of The Provider |
166522413 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
213 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
18514 |
Total Medicare Allowed Amount |
14059.74 |
Total Medicare Payment Amount |
10532.45 |
Total Medicare Standardized Payment Amount |
11691.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
2023 |
Total Drug Medicare AllowedAmount |
1297.69 |
Total Drug Medicare PaymentAmount |
1179.11 |
Total Drug Medicare Standardized Payment Amount |
1179.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
178 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
16491 |
Total Medical Medicare Allowed Amount |
12762.05 |
Total Medical Medicare Payment Amount |
9353.34 |
Total Medical Medicare Standardized Payment Amount |
10512.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0756 |