National Provider Identifier [NPI]: |
1881630804 |
Last Name Of The Provider |
SPINELLA |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
60 WESTWOOD AVE |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
WATERBURY |
Zip Code Of The Provider |
067082460 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
8563 |
Number Of Medicare Beneficiaries |
620 |
Total Submitted Charge Amount |
713055 |
Total Medicare Allowed Amount |
319641.53 |
Total Medicare Payment Amount |
242888.98 |
Total Medicare Standardized Payment Amount |
205739.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
460 |
Total Drug Medicare AllowedAmount |
75.99 |
Total Drug Medicare PaymentAmount |
59.56 |
Total Drug Medicare Standardized Payment Amount |
59.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
8534 |
Number Of Medicare Beneficiaries With Medical Services |
620 |
Total Medical Submitted Charge Amount |
712595 |
Total Medical Medicare Allowed Amount |
319565.54 |
Total Medical Medicare Payment Amount |
242829.42 |
Total Medical Medicare Standardized Payment Amount |
205680.39 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
231 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
381 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
565 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
446 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1628 |