National Provider Identifier [NPI]: |
1437307410 |
Last Name Of The Provider |
GATHECHA |
First Name Of The Provider |
EVELYN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5200 EASTERN AVE |
Street Address 2 Of The Provider |
MASON F LORD WEST TOWER 6TH FLOOR |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212242734 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
618 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
122459 |
Total Medicare Allowed Amount |
63047.3 |
Total Medicare Payment Amount |
49289.31 |
Total Medicare Standardized Payment Amount |
46912.04 |
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 |
15 |
Number Of Medical Services |
618 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
122459 |
Total Medical Medicare Allowed Amount |
63047.3 |
Total Medical Medicare Payment Amount |
49289.31 |
Total Medical Medicare Standardized Payment Amount |
46912.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
190 |
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 |
149 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.9988 |