National Provider Identifier [NPI]: |
1861490898 |
Last Name Of The Provider |
PEARL |
First Name Of The Provider |
ELLIOTT |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
203 HOSPITAL DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
GLEN BURNIE |
Zip Code Of The Provider |
210616904 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
2617.1 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
83461 |
Total Medicare Allowed Amount |
48501.77 |
Total Medicare Payment Amount |
35474.98 |
Total Medicare Standardized Payment Amount |
33599.83 |
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 |
21 |
Number Of Medical Services |
2617.1 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
83461 |
Total Medical Medicare Allowed Amount |
48501.77 |
Total Medical Medicare Payment Amount |
35474.98 |
Total Medical Medicare Standardized Payment Amount |
33599.83 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
29 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8408 |