National Provider Identifier [NPI]: |
1629069182 |
Last Name Of The Provider |
VELLAH |
First Name Of The Provider |
PREACHESS |
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 |
36377 TARPON DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEWES |
Zip Code Of The Provider |
199585056 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1306 |
Number Of Medicare Beneficiaries |
479 |
Total Submitted Charge Amount |
201224 |
Total Medicare Allowed Amount |
104353.64 |
Total Medicare Payment Amount |
81279.81 |
Total Medicare Standardized Payment Amount |
80793.93 |
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 |
13 |
Number Of Medical Services |
1306 |
Number Of Medicare Beneficiaries With Medical Services |
479 |
Total Medical Submitted Charge Amount |
201224 |
Total Medical Medicare Allowed Amount |
104353.64 |
Total Medical Medicare Payment Amount |
81279.81 |
Total Medical Medicare Standardized Payment Amount |
80793.93 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
251 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
432 |
Number Of Black or African American Beneficiaries |
35 |
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 |
377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
52 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.2147 |