National Provider Identifier [NPI]: |
1891858791 |
Last Name Of The Provider |
DIAMOND |
First Name Of The Provider |
HOWARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5210 108 STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORONA |
Zip Code Of The Provider |
11368 |
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 |
27 |
Number Of Services |
842 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
100278 |
Total Medicare Allowed Amount |
65230.7 |
Total Medicare Payment Amount |
50188.14 |
Total Medicare Standardized Payment Amount |
44305.4 |
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 |
27 |
Number Of Medical Services |
842 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
100278 |
Total Medical Medicare Allowed Amount |
65230.7 |
Total Medical Medicare Payment Amount |
50188.14 |
Total Medical Medicare Standardized Payment Amount |
44305.4 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
44 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
48 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8964 |