National Provider Identifier [NPI]: |
1497958169 |
Last Name Of The Provider |
COMPANION |
First Name Of The Provider |
RODNEY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3057 N SUSQUEHANNA TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHAMOKIN DAM |
Zip Code Of The Provider |
178769114 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1462 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
124338 |
Total Medicare Allowed Amount |
97960.38 |
Total Medicare Payment Amount |
68965.86 |
Total Medicare Standardized Payment Amount |
74693.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
251 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
6407 |
Total Drug Medicare AllowedAmount |
5179.28 |
Total Drug Medicare PaymentAmount |
4446.96 |
Total Drug Medicare Standardized Payment Amount |
4446.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1211 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
117931 |
Total Medical Medicare Allowed Amount |
92781.1 |
Total Medical Medicare Payment Amount |
64518.9 |
Total Medical Medicare Standardized Payment Amount |
70246.65 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0948 |