National Provider Identifier [NPI]: |
1184680183 |
Last Name Of The Provider |
MCCARTHY |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 EAST APPLE STREET |
Street Address 2 Of The Provider |
SUITE 5253 |
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
45409 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
194 |
Number Of Medicare Beneficiaries |
86 |
Total Submitted Charge Amount |
60325 |
Total Medicare Allowed Amount |
30568.39 |
Total Medicare Payment Amount |
22191.2 |
Total Medicare Standardized Payment Amount |
24533.48 |
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 |
18 |
Number Of Medical Services |
194 |
Number Of Medicare Beneficiaries With Medical Services |
86 |
Total Medical Submitted Charge Amount |
60325 |
Total Medical Medicare Allowed Amount |
30568.39 |
Total Medical Medicare Payment Amount |
22191.2 |
Total Medical Medicare Standardized Payment Amount |
24533.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
58 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
|
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
30 |
Average HCC Risk Score Of Beneficiaries |
1.5859 |