National Provider Identifier [NPI]: |
1447419056 |
Last Name Of The Provider |
GERENA |
First Name Of The Provider |
MARIELIA |
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 |
10755 FALLS ROAD, PAVILION I |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
21093 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
145 |
Number Of Services |
6854 |
Number Of Medicare Beneficiaries |
1483 |
Total Submitted Charge Amount |
1407909.44 |
Total Medicare Allowed Amount |
285066.93 |
Total Medicare Payment Amount |
221788.42 |
Total Medicare Standardized Payment Amount |
211376.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
4962 |
Number Of Medicare Beneficiaries With Drug Services |
138 |
Total Drug Submitted ChargeAmount |
13941 |
Total Drug Medicare AllowedAmount |
3607.48 |
Total Drug Medicare PaymentAmount |
2754.7 |
Total Drug Medicare Standardized Payment Amount |
2754.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
143 |
Number Of Medical Services |
1892 |
Number Of Medicare Beneficiaries With Medical Services |
1480 |
Total Medical Submitted Charge Amount |
1393968.44 |
Total Medical Medicare Allowed Amount |
281459.45 |
Total Medical Medicare Payment Amount |
219033.72 |
Total Medical Medicare Standardized Payment Amount |
208622.11 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
365 |
Number Of Beneficiaries Age 65 to 74 |
628 |
Number Of Beneficiaries Age 75 to 84 |
375 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
984 |
Number Of Male Beneficiaries |
499 |
Number Of Non Hispanic White Beneficiaries |
994 |
Number Of Black or African American Beneficiaries |
439 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1023 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
460 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3563 |