National Provider Identifier [NPI]: |
1508001496 |
Last Name Of The Provider |
GRATIA |
First Name Of The Provider |
CLAUDEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY DR |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE |
City Of The Provider |
HERSHEY |
Zip Code Of The Provider |
170332360 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
71 |
Total Submitted Charge Amount |
28500 |
Total Medicare Allowed Amount |
17425.44 |
Total Medicare Payment Amount |
13419.34 |
Total Medicare Standardized Payment Amount |
14722.09 |
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 |
11 |
Number Of Medical Services |
227 |
Number Of Medicare Beneficiaries With Medical Services |
71 |
Total Medical Submitted Charge Amount |
28500 |
Total Medical Medicare Allowed Amount |
17425.44 |
Total Medical Medicare Payment Amount |
13419.34 |
Total Medical Medicare Standardized Payment Amount |
14722.09 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
33 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
37 |
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 |
41 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
|
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
37 |
Average HCC Risk Score Of Beneficiaries |
1.911 |