National Provider Identifier [NPI]: |
1033113527 |
Last Name Of The Provider |
GIUSTRA |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6 GLEN COVE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKPORT |
Zip Code Of The Provider |
048564240 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
149 |
Number Of Services |
2961 |
Number Of Medicare Beneficiaries |
1663 |
Total Submitted Charge Amount |
363573 |
Total Medicare Allowed Amount |
90432.49 |
Total Medicare Payment Amount |
68427.36 |
Total Medicare Standardized Payment Amount |
72078.12 |
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 |
149 |
Number Of Medical Services |
2961 |
Number Of Medicare Beneficiaries With Medical Services |
1663 |
Total Medical Submitted Charge Amount |
363573 |
Total Medical Medicare Allowed Amount |
90432.49 |
Total Medical Medicare Payment Amount |
68427.36 |
Total Medical Medicare Standardized Payment Amount |
72078.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
270 |
Number Of Beneficiaries Age 65 to 74 |
505 |
Number Of Beneficiaries Age 75 to 84 |
467 |
Number Of Beneficiaries Age Greater 84 |
421 |
Number Of Female Beneficiaries |
996 |
Number Of Male Beneficiaries |
667 |
Number Of Non Hispanic White Beneficiaries |
1630 |
Number Of Black or African American Beneficiaries |
|
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 |
1012 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
651 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4382 |