National Provider Identifier [NPI]: |
1114098357 |
Last Name Of The Provider |
MAUGHAN |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6028 S RIDGELINE DR STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
OGDEN |
Zip Code Of The Provider |
844056906 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
4520 |
Number Of Medicare Beneficiaries |
547 |
Total Submitted Charge Amount |
514742 |
Total Medicare Allowed Amount |
252452.61 |
Total Medicare Payment Amount |
182860.18 |
Total Medicare Standardized Payment Amount |
192133.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
105 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
43826 |
Total Drug Medicare AllowedAmount |
25753.7 |
Total Drug Medicare PaymentAmount |
19734.26 |
Total Drug Medicare Standardized Payment Amount |
19734.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
4415 |
Number Of Medicare Beneficiaries With Medical Services |
547 |
Total Medical Submitted Charge Amount |
470916 |
Total Medical Medicare Allowed Amount |
226698.91 |
Total Medical Medicare Payment Amount |
163125.92 |
Total Medical Medicare Standardized Payment Amount |
172399.47 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
279 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
361 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
529 |
Number Of Black or African American Beneficiaries |
0 |
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 |
533 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8565 |