National Provider Identifier [NPI]: |
1730332701 |
Last Name Of The Provider |
BICKETT |
First Name Of The Provider |
MELISSA |
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 |
4760 BELPAR ST NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
CANTON |
Zip Code Of The Provider |
447183603 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
449 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
121157 |
Total Medicare Allowed Amount |
40985.08 |
Total Medicare Payment Amount |
30942.71 |
Total Medicare Standardized Payment Amount |
35265.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
280 |
Total Drug Medicare AllowedAmount |
151.25 |
Total Drug Medicare PaymentAmount |
110.08 |
Total Drug Medicare Standardized Payment Amount |
110.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
421 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
120877 |
Total Medical Medicare Allowed Amount |
40833.83 |
Total Medical Medicare Payment Amount |
30832.63 |
Total Medical Medicare Standardized Payment Amount |
35155.38 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
38 |
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 |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1492 |