National Provider Identifier [NPI]: |
1235143165 |
Last Name Of The Provider |
WEIDMAN |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1755 W MARKET ST |
Street Address 2 Of The Provider |
STE. A |
City Of The Provider |
AKRON |
Zip Code Of The Provider |
443137040 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1041 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
81282 |
Total Medicare Allowed Amount |
54857.9 |
Total Medicare Payment Amount |
41164.84 |
Total Medicare Standardized Payment Amount |
42965.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
210 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
3407 |
Total Drug Medicare AllowedAmount |
1813.01 |
Total Drug Medicare PaymentAmount |
1710.49 |
Total Drug Medicare Standardized Payment Amount |
1710.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
831 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
77875 |
Total Medical Medicare Allowed Amount |
53044.89 |
Total Medical Medicare Payment Amount |
39454.35 |
Total Medical Medicare Standardized Payment Amount |
41255 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
213 |
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 |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0394 |