National Provider Identifier [NPI]: |
1699750315 |
Last Name Of The Provider |
SKELSEY |
First Name Of The Provider |
MARAL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3800 RESERVOIR RD NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
200072113 |
State Code Of The Provider |
DC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
5490 |
Number Of Medicare Beneficiaries |
768 |
Total Submitted Charge Amount |
1060026.44 |
Total Medicare Allowed Amount |
669249.3 |
Total Medicare Payment Amount |
503597.49 |
Total Medicare Standardized Payment Amount |
431846 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
127 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
13435 |
Total Drug Medicare AllowedAmount |
10862.64 |
Total Drug Medicare PaymentAmount |
8506.28 |
Total Drug Medicare Standardized Payment Amount |
8506.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
5363 |
Number Of Medicare Beneficiaries With Medical Services |
768 |
Total Medical Submitted Charge Amount |
1046591.44 |
Total Medical Medicare Allowed Amount |
658386.66 |
Total Medical Medicare Payment Amount |
495091.21 |
Total Medical Medicare Standardized Payment Amount |
423339.72 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
344 |
Number Of Beneficiaries Age 75 to 84 |
271 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
474 |
Number Of Male Beneficiaries |
294 |
Number Of Non Hispanic White Beneficiaries |
718 |
Number Of Black or African American Beneficiaries |
11 |
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 |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.8506 |