National Provider Identifier [NPI]: |
1699723049 |
Last Name Of The Provider |
PERROTTI |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
251 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRANFORD |
Zip Code Of The Provider |
064054047 |
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 |
2580 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
268383 |
Total Medicare Allowed Amount |
142620.51 |
Total Medicare Payment Amount |
102931.63 |
Total Medicare Standardized Payment Amount |
97071.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
193 |
Number Of Medicare Beneficiaries With Drug Services |
143 |
Total Drug Submitted ChargeAmount |
7914 |
Total Drug Medicare AllowedAmount |
4373.9 |
Total Drug Medicare PaymentAmount |
4259.39 |
Total Drug Medicare Standardized Payment Amount |
4259.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
2387 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
260469 |
Total Medical Medicare Allowed Amount |
138246.61 |
Total Medical Medicare Payment Amount |
98672.24 |
Total Medical Medicare Standardized Payment Amount |
92812.11 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
161 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
324 |
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 |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.288 |