National Provider Identifier [NPI]: |
1811924574 |
Last Name Of The Provider |
COSENZA |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
238 HOSPITAL DR STE B |
Street Address 2 Of The Provider |
|
City Of The Provider |
UKIAH |
Zip Code Of The Provider |
95482 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
19326 |
Number Of Medicare Beneficiaries |
473 |
Total Submitted Charge Amount |
598544.61 |
Total Medicare Allowed Amount |
254300.71 |
Total Medicare Payment Amount |
187673.18 |
Total Medicare Standardized Payment Amount |
169391.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
16150 |
Number Of Medicare Beneficiaries With Drug Services |
146 |
Total Drug Submitted ChargeAmount |
20244 |
Total Drug Medicare AllowedAmount |
2133.33 |
Total Drug Medicare PaymentAmount |
1637.05 |
Total Drug Medicare Standardized Payment Amount |
1637.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
104 |
Number Of Medical Services |
3176 |
Number Of Medicare Beneficiaries With Medical Services |
473 |
Total Medical Submitted Charge Amount |
578300.61 |
Total Medical Medicare Allowed Amount |
252167.38 |
Total Medical Medicare Payment Amount |
186036.13 |
Total Medical Medicare Standardized Payment Amount |
167754.77 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
387 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
18 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4688 |