National Provider Identifier [NPI]: |
1962415604 |
Last Name Of The Provider |
MANZO |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
665 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGDALE |
Zip Code Of The Provider |
117354130 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
969 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
45912 |
Total Medicare Allowed Amount |
32016.76 |
Total Medicare Payment Amount |
25006 |
Total Medicare Standardized Payment Amount |
21806.79 |
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 |
9 |
Number Of Medical Services |
969 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
45912 |
Total Medical Medicare Allowed Amount |
32016.76 |
Total Medical Medicare Payment Amount |
25006 |
Total Medical Medicare Standardized Payment Amount |
21806.79 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
0 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5145 |