National Provider Identifier [NPI]: |
1336348887 |
Last Name Of The Provider |
SPADA |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 SILAS DEANE HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
WETHERSFIELD |
Zip Code Of The Provider |
061094229 |
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 |
77 |
Number Of Services |
1803 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
246458 |
Total Medicare Allowed Amount |
124713.12 |
Total Medicare Payment Amount |
87054.32 |
Total Medicare Standardized Payment Amount |
82038.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
248 |
Number Of Medicare Beneficiaries With Drug Services |
140 |
Total Drug Submitted ChargeAmount |
10206 |
Total Drug Medicare AllowedAmount |
4707.3 |
Total Drug Medicare PaymentAmount |
4544.13 |
Total Drug Medicare Standardized Payment Amount |
4544.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
1555 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
236252 |
Total Medical Medicare Allowed Amount |
120005.82 |
Total Medical Medicare Payment Amount |
82510.19 |
Total Medical Medicare Standardized Payment Amount |
77494.46 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0779 |