National Provider Identifier [NPI]: |
1669538260 |
Last Name Of The Provider |
ROMO |
First Name Of The Provider |
VICTOR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 S 11TH ST |
Street Address 2 Of The Provider |
SUITE 8490 |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191074824 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
273 |
Number Of Medicare Beneficiaries |
236 |
Total Submitted Charge Amount |
338464.04 |
Total Medicare Allowed Amount |
51708.38 |
Total Medicare Payment Amount |
40365.59 |
Total Medicare Standardized Payment Amount |
38018.94 |
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 |
42 |
Number Of Medical Services |
273 |
Number Of Medicare Beneficiaries With Medical Services |
236 |
Total Medical Submitted Charge Amount |
338464.04 |
Total Medical Medicare Allowed Amount |
51708.38 |
Total Medical Medicare Payment Amount |
40365.59 |
Total Medical Medicare Standardized Payment Amount |
38018.94 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
181 |
Number Of Black or African American Beneficiaries |
42 |
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 |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
31 |
Average HCC Risk Score Of Beneficiaries |
1.369 |