National Provider Identifier [NPI]: |
1932152196 |
Last Name Of The Provider |
ESTRELLA |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 N WOLFE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212870005 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
823 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
293409 |
Total Medicare Allowed Amount |
103611.47 |
Total Medicare Payment Amount |
80280.19 |
Total Medicare Standardized Payment Amount |
76453.5 |
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 |
19 |
Number Of Medical Services |
823 |
Number Of Medicare Beneficiaries With Medical Services |
250 |
Total Medical Submitted Charge Amount |
293409 |
Total Medical Medicare Allowed Amount |
103611.47 |
Total Medical Medicare Payment Amount |
80280.19 |
Total Medical Medicare Standardized Payment Amount |
76453.5 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
82 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
6.5007 |