National Provider Identifier [NPI]: |
1639118565 |
Last Name Of The Provider |
EROL |
First Name Of The Provider |
ALI |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
901 WETHERSFIELD AVE |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
06114 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
679 |
Number Of Medicare Beneficiaries |
197 |
Total Submitted Charge Amount |
113513 |
Total Medicare Allowed Amount |
53692.36 |
Total Medicare Payment Amount |
37527.48 |
Total Medicare Standardized Payment Amount |
34828.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
917 |
Total Drug Medicare AllowedAmount |
118.75 |
Total Drug Medicare PaymentAmount |
93.09 |
Total Drug Medicare Standardized Payment Amount |
93.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
643 |
Number Of Medicare Beneficiaries With Medical Services |
197 |
Total Medical Submitted Charge Amount |
112596 |
Total Medical Medicare Allowed Amount |
53573.61 |
Total Medical Medicare Payment Amount |
37434.39 |
Total Medical Medicare Standardized Payment Amount |
34734.95 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
164 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0938 |