National Provider Identifier [NPI]: |
1083818512 |
Last Name Of The Provider |
ABRAHAM |
First Name Of The Provider |
MATHEW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 SPRUCE STREET |
Street Address 2 Of The Provider |
1 GROUND WHITE BUILDING |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191044206 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1320 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
102636 |
Total Medicare Allowed Amount |
48282.32 |
Total Medicare Payment Amount |
30648.11 |
Total Medicare Standardized Payment Amount |
25460.64 |
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 |
36 |
Number Of Medical Services |
1320 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
102636 |
Total Medical Medicare Allowed Amount |
48282.32 |
Total Medical Medicare Payment Amount |
30648.11 |
Total Medical Medicare Standardized Payment Amount |
25460.64 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
192 |
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 |
182 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1731 |