National Provider Identifier [NPI]: |
1790722981 |
Last Name Of The Provider |
JIH |
First Name Of The Provider |
DEBRA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
822 PINE ST STE 2A |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191076187 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
6644 |
Number Of Medicare Beneficiaries |
2642 |
Total Submitted Charge Amount |
909188 |
Total Medicare Allowed Amount |
367851.31 |
Total Medicare Payment Amount |
278753.46 |
Total Medicare Standardized Payment Amount |
220401.25 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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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 |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
1398 |
Number Of Beneficiaries Age 75 to 84 |
768 |
Number Of Beneficiaries Age Greater 84 |
363 |
Number Of Female Beneficiaries |
1305 |
Number Of Male Beneficiaries |
1337 |
Number Of Non Hispanic White Beneficiaries |
2507 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
43 |
Number Of Beneficiaries With Medicare Only Entitlement |
2538 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9874 |