National Provider Identifier [NPI]: |
1598815870 |
Last Name Of The Provider |
CEDRO |
First Name Of The Provider |
MARRIANNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4940 EASTERN AVENUE |
Street Address 2 Of The Provider |
JOHNS HOPKINS BAYVIEW MEDICAL CENTER |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212242780 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
192 |
Number Of Medicare Beneficiaries |
158 |
Total Submitted Charge Amount |
42718.99 |
Total Medicare Allowed Amount |
17779.04 |
Total Medicare Payment Amount |
13876.68 |
Total Medicare Standardized Payment Amount |
15428.35 |
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 |
192 |
Number Of Medicare Beneficiaries With Medical Services |
158 |
Total Medical Submitted Charge Amount |
42718.99 |
Total Medical Medicare Allowed Amount |
17779.04 |
Total Medical Medicare Payment Amount |
13876.68 |
Total Medical Medicare Standardized Payment Amount |
15428.35 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
93 |
Number Of Black or African American Beneficiaries |
50 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
1.747 |