National Provider Identifier [NPI]: |
1609814565 |
Last Name Of The Provider |
MCDERMOTT |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8311 WARREN H ABERNATHY HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPARTENBURG |
Zip Code Of The Provider |
293011249 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
715 |
Number Of Medicare Beneficiaries |
155 |
Total Submitted Charge Amount |
50496.06 |
Total Medicare Allowed Amount |
25154.26 |
Total Medicare Payment Amount |
18507.13 |
Total Medicare Standardized Payment Amount |
20678.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
65 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
1627.15 |
Total Drug Medicare AllowedAmount |
1217.74 |
Total Drug Medicare PaymentAmount |
1190.7 |
Total Drug Medicare Standardized Payment Amount |
1190.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
650 |
Number Of Medicare Beneficiaries With Medical Services |
155 |
Total Medical Submitted Charge Amount |
48868.91 |
Total Medical Medicare Allowed Amount |
23936.52 |
Total Medical Medicare Payment Amount |
17316.43 |
Total Medical Medicare Standardized Payment Amount |
19487.36 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
140 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
10 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.5222 |