National Provider Identifier [NPI]: |
1841396827 |
Last Name Of The Provider |
MEDWIED |
First Name Of The Provider |
MARILYN |
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 |
7901 E 22ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857108509 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
420 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
74770 |
Total Medicare Allowed Amount |
19760.79 |
Total Medicare Payment Amount |
13954.58 |
Total Medicare Standardized Payment Amount |
14408.77 |
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 |
14 |
Number Of Medical Services |
420 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
74770 |
Total Medical Medicare Allowed Amount |
19760.79 |
Total Medical Medicare Payment Amount |
13954.58 |
Total Medical Medicare Standardized Payment Amount |
14408.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
11 |
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 |
4 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
5 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6958 |