National Provider Identifier [NPI]: |
1013171800 |
Last Name Of The Provider |
SCHMIDT |
First Name Of The Provider |
KEILLA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2570 HAYMAKER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONROEVILLE |
Zip Code Of The Provider |
151463513 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
431 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
147310 |
Total Medicare Allowed Amount |
59070.93 |
Total Medicare Payment Amount |
45558.42 |
Total Medicare Standardized Payment Amount |
42354.23 |
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 |
33 |
Number Of Medical Services |
431 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
147310 |
Total Medical Medicare Allowed Amount |
59070.93 |
Total Medical Medicare Payment Amount |
45558.42 |
Total Medical Medicare Standardized Payment Amount |
42354.23 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
77 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
23 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.7717 |