National Provider Identifier [NPI]: |
1063650703 |
Last Name Of The Provider |
VOCK |
First Name Of The Provider |
TRACIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20251 CENTURY BLVD |
Street Address 2 Of The Provider |
SUITE 130 |
City Of The Provider |
GERMANTOWN |
Zip Code Of The Provider |
208741162 |
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 |
20 |
Number Of Services |
587 |
Number Of Medicare Beneficiaries |
479 |
Total Submitted Charge Amount |
215656 |
Total Medicare Allowed Amount |
64679.86 |
Total Medicare Payment Amount |
49485.28 |
Total Medicare Standardized Payment Amount |
58156.66 |
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 |
20 |
Number Of Medical Services |
587 |
Number Of Medicare Beneficiaries With Medical Services |
479 |
Total Medical Submitted Charge Amount |
215656 |
Total Medical Medicare Allowed Amount |
64679.86 |
Total Medical Medicare Payment Amount |
49485.28 |
Total Medical Medicare Standardized Payment Amount |
58156.66 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
293 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
403 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6252 |