National Provider Identifier [NPI]: |
1801098033 |
Last Name Of The Provider |
BOODOOSINGH |
First Name Of The Provider |
DEV |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
TORRE SAN LUCAS SUITE 701 |
Street Address 2 Of The Provider |
TITO CASTRO AVE. |
City Of The Provider |
PONCE |
Zip Code Of The Provider |
00780 |
State Code Of The Provider |
PR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1059 |
Number Of Medicare Beneficiaries |
127 |
Total Submitted Charge Amount |
126125.89 |
Total Medicare Allowed Amount |
76496.95 |
Total Medicare Payment Amount |
59340.53 |
Total Medicare Standardized Payment Amount |
67109.48 |
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 |
29 |
Number Of Medical Services |
1059 |
Number Of Medicare Beneficiaries With Medical Services |
127 |
Total Medical Submitted Charge Amount |
126125.89 |
Total Medical Medicare Allowed Amount |
76496.95 |
Total Medical Medicare Payment Amount |
59340.53 |
Total Medical Medicare Standardized Payment Amount |
67109.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
68 |
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 |
9 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.8143 |