National Provider Identifier [NPI]: |
1962499418 |
Last Name Of The Provider |
FORTE |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
703 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PATERSON |
Zip Code Of The Provider |
075032621 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
553 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
132594 |
Total Medicare Allowed Amount |
42217.36 |
Total Medicare Payment Amount |
31675.67 |
Total Medicare Standardized Payment Amount |
31310.25 |
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 |
103 |
Number Of Medical Services |
553 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
132594 |
Total Medical Medicare Allowed Amount |
42217.36 |
Total Medical Medicare Payment Amount |
31675.67 |
Total Medical Medicare Standardized Payment Amount |
31310.25 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0557 |