National Provider Identifier [NPI]: |
1649447731 |
Last Name Of The Provider |
STIERMAN |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12780 ROACHTON RD # 1 |
Street Address 2 Of The Provider |
|
City Of The Provider |
PERRYSBURG |
Zip Code Of The Provider |
435511350 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
4624 |
Number Of Medicare Beneficiaries |
1400 |
Total Submitted Charge Amount |
453194.25 |
Total Medicare Allowed Amount |
291167.62 |
Total Medicare Payment Amount |
221808.52 |
Total Medicare Standardized Payment Amount |
204282.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
175 |
Total Drug Medicare AllowedAmount |
62.39 |
Total Drug Medicare PaymentAmount |
46.13 |
Total Drug Medicare Standardized Payment Amount |
46.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
4589 |
Number Of Medicare Beneficiaries With Medical Services |
1400 |
Total Medical Submitted Charge Amount |
453019.25 |
Total Medical Medicare Allowed Amount |
291105.23 |
Total Medical Medicare Payment Amount |
221762.39 |
Total Medical Medicare Standardized Payment Amount |
204236.82 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
715 |
Number Of Beneficiaries Age 75 to 84 |
463 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
779 |
Number Of Male Beneficiaries |
621 |
Number Of Non Hispanic White Beneficiaries |
1344 |
Number Of Black or African American Beneficiaries |
|
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 |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
1376 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8614 |