National Provider Identifier [NPI]: |
1831129477 |
Last Name Of The Provider |
MANCINI |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2881 MONROE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DEARBORN |
Zip Code Of The Provider |
481243475 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
2967 |
Number Of Medicare Beneficiaries |
1106 |
Total Submitted Charge Amount |
756445.2 |
Total Medicare Allowed Amount |
209679.76 |
Total Medicare Payment Amount |
156684.87 |
Total Medicare Standardized Payment Amount |
154274.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
80 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
4619.2 |
Total Drug Medicare AllowedAmount |
3429.18 |
Total Drug Medicare PaymentAmount |
2438.04 |
Total Drug Medicare Standardized Payment Amount |
2438.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
2887 |
Number Of Medicare Beneficiaries With Medical Services |
1106 |
Total Medical Submitted Charge Amount |
751826 |
Total Medical Medicare Allowed Amount |
206250.58 |
Total Medical Medicare Payment Amount |
154246.83 |
Total Medical Medicare Standardized Payment Amount |
151836.19 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
179 |
Number Of Beneficiaries Age 65 to 74 |
383 |
Number Of Beneficiaries Age 75 to 84 |
322 |
Number Of Beneficiaries Age Greater 84 |
222 |
Number Of Female Beneficiaries |
612 |
Number Of Male Beneficiaries |
494 |
Number Of Non Hispanic White Beneficiaries |
906 |
Number Of Black or African American Beneficiaries |
122 |
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
26 |
Number Of Beneficiaries With Medicare Only Entitlement |
851 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
255 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7902 |