National Provider Identifier [NPI]: |
1689695025 |
Last Name Of The Provider |
COHEN |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 S LANDMARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
474033239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
115 |
Number Of Services |
5745 |
Number Of Medicare Beneficiaries |
795 |
Total Submitted Charge Amount |
390137 |
Total Medicare Allowed Amount |
208299.6 |
Total Medicare Payment Amount |
156224.68 |
Total Medicare Standardized Payment Amount |
163263.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
488 |
Number Of Medicare Beneficiaries With Drug Services |
255 |
Total Drug Submitted ChargeAmount |
57351 |
Total Drug Medicare AllowedAmount |
28803.46 |
Total Drug Medicare PaymentAmount |
25791.53 |
Total Drug Medicare Standardized Payment Amount |
25791.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
100 |
Number Of Medical Services |
5257 |
Number Of Medicare Beneficiaries With Medical Services |
795 |
Total Medical Submitted Charge Amount |
332786 |
Total Medical Medicare Allowed Amount |
179496.14 |
Total Medical Medicare Payment Amount |
130433.15 |
Total Medical Medicare Standardized Payment Amount |
137471.68 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
171 |
Number Of Female Beneficiaries |
559 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
764 |
Number Of Black or African American Beneficiaries |
12 |
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 |
660 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1534 |