National Provider Identifier [NPI]: |
1568512499 |
Last Name Of The Provider |
MCLEAN |
First Name Of The Provider |
RHONDALYN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 CIVIC CENTER BLVD |
Street Address 2 Of The Provider |
EAST PAVILION, 2ND FLOOR |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191044306 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1379 |
Number Of Medicare Beneficiaries |
383 |
Total Submitted Charge Amount |
221463 |
Total Medicare Allowed Amount |
112486.96 |
Total Medicare Payment Amount |
85989.98 |
Total Medicare Standardized Payment Amount |
83830.09 |
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 |
24 |
Number Of Medical Services |
1379 |
Number Of Medicare Beneficiaries With Medical Services |
383 |
Total Medical Submitted Charge Amount |
221463 |
Total Medical Medicare Allowed Amount |
112486.96 |
Total Medical Medicare Payment Amount |
85989.98 |
Total Medical Medicare Standardized Payment Amount |
83830.09 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
133 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
257 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
43 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.1184 |