National Provider Identifier [NPI]: |
1326045915 |
Last Name Of The Provider |
SCHAEN |
First Name Of The Provider |
LORI |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4360 CHAMBLEE DUNWOODY RD |
Street Address 2 Of The Provider |
STE 260 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303411049 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
976 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
158869 |
Total Medicare Allowed Amount |
67030.83 |
Total Medicare Payment Amount |
47822.95 |
Total Medicare Standardized Payment Amount |
46736.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
7520 |
Total Drug Medicare AllowedAmount |
5432.17 |
Total Drug Medicare PaymentAmount |
4224.2 |
Total Drug Medicare Standardized Payment Amount |
4224.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
935 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
151349 |
Total Medical Medicare Allowed Amount |
61598.66 |
Total Medical Medicare Payment Amount |
43598.75 |
Total Medical Medicare Standardized Payment Amount |
42512.19 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
165 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
16 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8098 |