National Provider Identifier [NPI]: |
1851379051 |
Last Name Of The Provider |
CHUROSH |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9901 MEDICAL CENTER DRIVE |
Street Address 2 Of The Provider |
SHADY GROVE ADVENTIST HOSPITAL |
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
20850 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
780 |
Number Of Medicare Beneficiaries |
678 |
Total Submitted Charge Amount |
201087.15 |
Total Medicare Allowed Amount |
112155.69 |
Total Medicare Payment Amount |
82725.02 |
Total Medicare Standardized Payment Amount |
81639.61 |
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 |
26 |
Number Of Medical Services |
780 |
Number Of Medicare Beneficiaries With Medical Services |
678 |
Total Medical Submitted Charge Amount |
201087.15 |
Total Medical Medicare Allowed Amount |
112155.69 |
Total Medical Medicare Payment Amount |
82725.02 |
Total Medical Medicare Standardized Payment Amount |
81639.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
296 |
Number Of Non Hispanic White Beneficiaries |
648 |
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 |
585 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6668 |