National Provider Identifier [NPI]: |
1043417389 |
Last Name Of The Provider |
DELEMOS |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
STONY BROOK UNIVERSITY MEDICAL CENTER |
Street Address 2 Of The Provider |
100 NICOLLS ROAD, HSC, L4, RM 060 |
City Of The Provider |
STONY BROOK |
Zip Code Of The Provider |
117948480 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
315 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
435500 |
Total Medicare Allowed Amount |
42448.39 |
Total Medicare Payment Amount |
33209.15 |
Total Medicare Standardized Payment Amount |
29225.64 |
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 |
45 |
Number Of Medical Services |
315 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
435500 |
Total Medical Medicare Allowed Amount |
42448.39 |
Total Medical Medicare Payment Amount |
33209.15 |
Total Medical Medicare Standardized Payment Amount |
29225.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
237 |
Number Of Black or African American Beneficiaries |
19 |
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 |
214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8064 |