National Provider Identifier [NPI]: |
1194719401 |
Last Name Of The Provider |
STONE |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
5722 |
Number Of Medicare Beneficiaries |
2970 |
Total Submitted Charge Amount |
790497 |
Total Medicare Allowed Amount |
201720.19 |
Total Medicare Payment Amount |
150106.82 |
Total Medicare Standardized Payment Amount |
137888.47 |
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 |
40 |
Number Of Medical Services |
5722 |
Number Of Medicare Beneficiaries With Medical Services |
2970 |
Total Medical Submitted Charge Amount |
790497 |
Total Medical Medicare Allowed Amount |
201720.19 |
Total Medical Medicare Payment Amount |
150106.82 |
Total Medical Medicare Standardized Payment Amount |
137888.47 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
207 |
Number Of Beneficiaries Age 65 to 74 |
1281 |
Number Of Beneficiaries Age 75 to 84 |
988 |
Number Of Beneficiaries Age Greater 84 |
494 |
Number Of Female Beneficiaries |
1449 |
Number Of Male Beneficiaries |
1521 |
Number Of Non Hispanic White Beneficiaries |
2891 |
Number Of Black or African American Beneficiaries |
17 |
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 |
38 |
Number Of Beneficiaries With Medicare Only Entitlement |
2745 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0376 |