National Provider Identifier [NPI]: |
1053616631 |
Last Name Of The Provider |
FOX-MELLUL |
First Name Of The Provider |
JODI |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
34 COLSON LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
MULLICA HILL |
Zip Code Of The Provider |
080621502 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
593 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
130965 |
Total Medicare Allowed Amount |
66077.52 |
Total Medicare Payment Amount |
49539.15 |
Total Medicare Standardized Payment Amount |
46460.36 |
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 |
7 |
Number Of Medical Services |
593 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
130965 |
Total Medical Medicare Allowed Amount |
66077.52 |
Total Medical Medicare Payment Amount |
49539.15 |
Total Medical Medicare Standardized Payment Amount |
46460.36 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
163 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4745 |