National Provider Identifier [NPI]: |
1487638037 |
Last Name Of The Provider |
EDWARDS |
First Name Of The Provider |
LANCE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
118 N COUNTRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT JEFFERSON |
Zip Code Of The Provider |
117772120 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
2238 |
Number Of Medicare Beneficiaries |
831 |
Total Submitted Charge Amount |
502219 |
Total Medicare Allowed Amount |
180062.45 |
Total Medicare Payment Amount |
134865.08 |
Total Medicare Standardized Payment Amount |
118984 |
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 |
34 |
Number Of Medical Services |
2238 |
Number Of Medicare Beneficiaries With Medical Services |
831 |
Total Medical Submitted Charge Amount |
502219 |
Total Medical Medicare Allowed Amount |
180062.45 |
Total Medical Medicare Payment Amount |
134865.08 |
Total Medical Medicare Standardized Payment Amount |
118984 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
483 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
831 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
752 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
762 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8964 |