National Provider Identifier [NPI]: |
1578507711 |
Last Name Of The Provider |
DEGIACOMO |
First Name Of The Provider |
FRANK |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6 BRIGHTON RD |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
CLIFTON |
Zip Code Of The Provider |
070121647 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
3649 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
153104.8 |
Total Medicare Allowed Amount |
125627.78 |
Total Medicare Payment Amount |
93357.32 |
Total Medicare Standardized Payment Amount |
86212.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
120 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
4727.74 |
Total Drug Medicare AllowedAmount |
3827.18 |
Total Drug Medicare PaymentAmount |
3699.76 |
Total Drug Medicare Standardized Payment Amount |
3699.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
3529 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
148377.06 |
Total Medical Medicare Allowed Amount |
121800.6 |
Total Medical Medicare Payment Amount |
89657.56 |
Total Medical Medicare Standardized Payment Amount |
82512.81 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3213 |