National Provider Identifier [NPI]: |
1619158896 |
Last Name Of The Provider |
SANDEL |
First Name Of The Provider |
OLGA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 WASHINGTON HEIGHTS MED CTR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTMINSTER |
Zip Code Of The Provider |
211575633 |
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 |
15 |
Number Of Services |
205 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
157063 |
Total Medicare Allowed Amount |
24681.4 |
Total Medicare Payment Amount |
19096.3 |
Total Medicare Standardized Payment Amount |
21481.46 |
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 |
15 |
Number Of Medical Services |
205 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
157063 |
Total Medical Medicare Allowed Amount |
24681.4 |
Total Medical Medicare Payment Amount |
19096.3 |
Total Medical Medicare Standardized Payment Amount |
21481.46 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
130 |
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 |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.413 |