National Provider Identifier [NPI]: |
1457396475 |
Last Name Of The Provider |
KIRIAKIDOU |
First Name Of The Provider |
MARIANTHI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 S 9TH ST |
Street Address 2 Of The Provider |
STE 600 |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191076810 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
2897 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
319200 |
Total Medicare Allowed Amount |
185164.4 |
Total Medicare Payment Amount |
143169.37 |
Total Medicare Standardized Payment Amount |
139637.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
2422 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
223095 |
Total Drug Medicare AllowedAmount |
129889.41 |
Total Drug Medicare PaymentAmount |
101781.46 |
Total Drug Medicare Standardized Payment Amount |
101781.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
475 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
96105 |
Total Medical Medicare Allowed Amount |
55274.99 |
Total Medical Medicare Payment Amount |
41387.91 |
Total Medical Medicare Standardized Payment Amount |
37856.25 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
79 |
Number Of Black or African American Beneficiaries |
56 |
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8153 |