National Provider Identifier [NPI]: |
1427362128 |
Last Name Of The Provider |
DEANGELIS |
First Name Of The Provider |
EILEEN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4755 OGLETOWN STANTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197180001 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
228 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
71884 |
Total Medicare Allowed Amount |
17594.44 |
Total Medicare Payment Amount |
13419.82 |
Total Medicare Standardized Payment Amount |
15721.31 |
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 |
19 |
Number Of Medical Services |
228 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
71884 |
Total Medical Medicare Allowed Amount |
17594.44 |
Total Medical Medicare Payment Amount |
13419.82 |
Total Medical Medicare Standardized Payment Amount |
15721.31 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
76 |
Number Of Black or African American Beneficiaries |
98 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4979 |