National Provider Identifier [NPI]: |
1720036817 |
Last Name Of The Provider |
HARVEY |
First Name Of The Provider |
KATHY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
140 STOLLINGS AVE STE 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOGAN |
Zip Code Of The Provider |
256014035 |
State Code Of The Provider |
WV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2020 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
223875.28 |
Total Medicare Allowed Amount |
189108.84 |
Total Medicare Payment Amount |
138711.12 |
Total Medicare Standardized Payment Amount |
150494.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
1680 |
Total Drug Medicare AllowedAmount |
1279.52 |
Total Drug Medicare PaymentAmount |
1253.8 |
Total Drug Medicare Standardized Payment Amount |
1253.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1936 |
Number Of Medicare Beneficiaries With Medical Services |
393 |
Total Medical Submitted Charge Amount |
222195.28 |
Total Medical Medicare Allowed Amount |
187829.32 |
Total Medical Medicare Payment Amount |
137457.32 |
Total Medical Medicare Standardized Payment Amount |
149240.49 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
179 |
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 |
268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6923 |