National Provider Identifier [NPI]: |
1164414421 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
CHARLES |
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 |
8601 VETERANS HWY |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
MILLERSVILLE |
Zip Code Of The Provider |
211081547 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
11201 |
Number Of Medicare Beneficiaries |
3474 |
Total Submitted Charge Amount |
732738.92 |
Total Medicare Allowed Amount |
187671.22 |
Total Medicare Payment Amount |
142643.11 |
Total Medicare Standardized Payment Amount |
141594.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
2892 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
751.92 |
Total Drug Medicare AllowedAmount |
547.15 |
Total Drug Medicare PaymentAmount |
428.99 |
Total Drug Medicare Standardized Payment Amount |
428.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
8309 |
Number Of Medicare Beneficiaries With Medical Services |
3474 |
Total Medical Submitted Charge Amount |
731987 |
Total Medical Medicare Allowed Amount |
187124.07 |
Total Medical Medicare Payment Amount |
142214.12 |
Total Medical Medicare Standardized Payment Amount |
141165.6 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
967 |
Number Of Beneficiaries Age 65 to 74 |
1325 |
Number Of Beneficiaries Age 75 to 84 |
863 |
Number Of Beneficiaries Age Greater 84 |
319 |
Number Of Female Beneficiaries |
1736 |
Number Of Male Beneficiaries |
1738 |
Number Of Non Hispanic White Beneficiaries |
1945 |
Number Of Black or African American Beneficiaries |
1372 |
Number Of AsianPacific Islander Beneficiaries |
51 |
Number Of Hispanic Beneficiaries |
54 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1065 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.6916 |