National Provider Identifier [NPI]: |
1639138076 |
Last Name Of The Provider |
COHICK |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2151 LINGLESTOWN RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
HARRISBURG |
Zip Code Of The Provider |
171109499 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1751 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
171680.5 |
Total Medicare Allowed Amount |
86977.51 |
Total Medicare Payment Amount |
63542.53 |
Total Medicare Standardized Payment Amount |
66265.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
129 |
Number Of Medicare Beneficiaries With Drug Services |
115 |
Total Drug Submitted ChargeAmount |
5696 |
Total Drug Medicare AllowedAmount |
4569.99 |
Total Drug Medicare PaymentAmount |
4462.64 |
Total Drug Medicare Standardized Payment Amount |
4462.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1622 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
165984.5 |
Total Medical Medicare Allowed Amount |
82407.52 |
Total Medical Medicare Payment Amount |
59079.89 |
Total Medical Medicare Standardized Payment Amount |
61802.98 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
225 |
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9652 |