National Provider Identifier [NPI]: |
1871515841 |
Last Name Of The Provider |
UGEL |
First Name Of The Provider |
ARTHUR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5454 WISCONSIN AVE |
Street Address 2 Of The Provider |
#745 |
City Of The Provider |
CHEVY CHASE |
Zip Code Of The Provider |
208156901 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
4377 |
Number Of Medicare Beneficiaries |
1064 |
Total Submitted Charge Amount |
275932 |
Total Medicare Allowed Amount |
212493.33 |
Total Medicare Payment Amount |
145006.51 |
Total Medicare Standardized Payment Amount |
124336.86 |
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 |
19 |
Number Of Medical Services |
4377 |
Number Of Medicare Beneficiaries With Medical Services |
1064 |
Total Medical Submitted Charge Amount |
275932 |
Total Medical Medicare Allowed Amount |
212493.33 |
Total Medical Medicare Payment Amount |
145006.51 |
Total Medical Medicare Standardized Payment Amount |
124336.86 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
489 |
Number Of Beneficiaries Age 75 to 84 |
379 |
Number Of Beneficiaries Age Greater 84 |
185 |
Number Of Female Beneficiaries |
546 |
Number Of Male Beneficiaries |
518 |
Number Of Non Hispanic White Beneficiaries |
987 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8204 |