National Provider Identifier [NPI]: |
1932244969 |
Last Name Of The Provider |
RHODES |
First Name Of The Provider |
MARINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24400 CHAGRIN BLVD |
Street Address 2 Of The Provider |
UNIT 102 |
City Of The Provider |
BEACHWOOD |
Zip Code Of The Provider |
441225642 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
604 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
164800 |
Total Medicare Allowed Amount |
57196.59 |
Total Medicare Payment Amount |
44673.62 |
Total Medicare Standardized Payment Amount |
55328.14 |
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 |
7 |
Number Of Medical Services |
604 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
164800 |
Total Medical Medicare Allowed Amount |
57196.59 |
Total Medical Medicare Payment Amount |
44673.62 |
Total Medical Medicare Standardized Payment Amount |
55328.14 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
97 |
Number Of Female Beneficiaries |
307 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
404 |
Number Of Black or African American Beneficiaries |
62 |
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 |
440 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1782 |