National Provider Identifier [NPI]: |
1891767661 |
Last Name Of The Provider |
COUNSELL |
First Name Of The Provider |
CHERYL |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 S SEACREST BLVD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
BOYNTON BEACH |
Zip Code Of The Provider |
334357960 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
155 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
31855 |
Total Medicare Allowed Amount |
21461.02 |
Total Medicare Payment Amount |
16079.06 |
Total Medicare Standardized Payment Amount |
15106.21 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
75 |
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
32 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1021 |