National Provider Identifier [NPI]: |
1265488431 |
Last Name Of The Provider |
ROY |
First Name Of The Provider |
SUJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
RN, CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2700 N CHARLES ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212184300 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
997 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
74309.94 |
Total Medicare Allowed Amount |
61887.77 |
Total Medicare Payment Amount |
47606.83 |
Total Medicare Standardized Payment Amount |
54042.43 |
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 |
5 |
Number Of Medical Services |
997 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
74309.94 |
Total Medical Medicare Allowed Amount |
61887.77 |
Total Medical Medicare Payment Amount |
47606.83 |
Total Medical Medicare Standardized Payment Amount |
54042.43 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
176 |
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 |
116 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
68 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.2058 |