National Provider Identifier [NPI]: |
1245236918 |
Last Name Of The Provider |
RAIMONDO |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1050 WARWICK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARWICK |
Zip Code Of The Provider |
028883655 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
4113 |
Number Of Medicare Beneficiaries |
693 |
Total Submitted Charge Amount |
566721 |
Total Medicare Allowed Amount |
370674.52 |
Total Medicare Payment Amount |
279567.9 |
Total Medicare Standardized Payment Amount |
278458.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
216 |
Number Of Medicare Beneficiaries With Drug Services |
162 |
Total Drug Submitted ChargeAmount |
6552 |
Total Drug Medicare AllowedAmount |
5044.05 |
Total Drug Medicare PaymentAmount |
4937.97 |
Total Drug Medicare Standardized Payment Amount |
4937.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
3897 |
Number Of Medicare Beneficiaries With Medical Services |
693 |
Total Medical Submitted Charge Amount |
560169 |
Total Medical Medicare Allowed Amount |
365630.47 |
Total Medical Medicare Payment Amount |
274629.93 |
Total Medical Medicare Standardized Payment Amount |
273520.37 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
169 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
398 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
657 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
519 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
31 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
64 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.1547 |