National Provider Identifier [NPI]: |
1578557252 |
Last Name Of The Provider |
CHRISTO |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26 MANCHESTER SQ |
Street Address 2 Of The Provider |
UNIT 1 |
City Of The Provider |
PORTSMOUTH |
Zip Code Of The Provider |
038012889 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1456 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
257204 |
Total Medicare Allowed Amount |
128581.07 |
Total Medicare Payment Amount |
92217.61 |
Total Medicare Standardized Payment Amount |
92029.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
5946 |
Total Drug Medicare AllowedAmount |
2245.39 |
Total Drug Medicare PaymentAmount |
2199.43 |
Total Drug Medicare Standardized Payment Amount |
2199.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1364 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
251258 |
Total Medical Medicare Allowed Amount |
126335.68 |
Total Medical Medicare Payment Amount |
90018.18 |
Total Medical Medicare Standardized Payment Amount |
89830.19 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
395 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
359 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0757 |