National Provider Identifier [NPI]: |
1205872215 |
Last Name Of The Provider |
FLOTTE |
First Name Of The Provider |
SYLVESTER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M,D, |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11155 DUNN RD |
Street Address 2 Of The Provider |
SUITE 207 NORTH |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631366150 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
626 |
Number Of Medicare Beneficiaries |
155 |
Total Submitted Charge Amount |
50653.95 |
Total Medicare Allowed Amount |
42439.34 |
Total Medicare Payment Amount |
27955.45 |
Total Medicare Standardized Payment Amount |
28492.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
65 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
2835 |
Total Drug Medicare AllowedAmount |
1158.94 |
Total Drug Medicare PaymentAmount |
1135.64 |
Total Drug Medicare Standardized Payment Amount |
1135.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
561 |
Number Of Medicare Beneficiaries With Medical Services |
155 |
Total Medical Submitted Charge Amount |
47818.95 |
Total Medical Medicare Allowed Amount |
41280.4 |
Total Medical Medicare Payment Amount |
26819.81 |
Total Medical Medicare Standardized Payment Amount |
27356.37 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1268 |