National Provider Identifier [NPI]: |
1902915713 |
Last Name Of The Provider |
ROSENBERG |
First Name Of The Provider |
RALPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36 EAST MAIN STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
AVON |
Zip Code Of The Provider |
060013828 |
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 |
67 |
Number Of Services |
5860 |
Number Of Medicare Beneficiaries |
535 |
Total Submitted Charge Amount |
704780 |
Total Medicare Allowed Amount |
376391.95 |
Total Medicare Payment Amount |
290875.13 |
Total Medicare Standardized Payment Amount |
270778.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
410 |
Number Of Medicare Beneficiaries With Drug Services |
189 |
Total Drug Submitted ChargeAmount |
8650 |
Total Drug Medicare AllowedAmount |
4907.03 |
Total Drug Medicare PaymentAmount |
4706.6 |
Total Drug Medicare Standardized Payment Amount |
4706.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
5450 |
Number Of Medicare Beneficiaries With Medical Services |
535 |
Total Medical Submitted Charge Amount |
696130 |
Total Medical Medicare Allowed Amount |
371484.92 |
Total Medical Medicare Payment Amount |
286168.53 |
Total Medical Medicare Standardized Payment Amount |
266071.51 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
507 |
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 |
487 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9917 |