National Provider Identifier [NPI]: |
1487712972 |
Last Name Of The Provider |
PEPE |
First Name Of The Provider |
VINCENT |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
816 BROAD ST |
Street Address 2 Of The Provider |
BLD 1 UNIT 21 |
City Of The Provider |
MERIDEN |
Zip Code Of The Provider |
06450 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
518 |
Number Of Medicare Beneficiaries |
282 |
Total Submitted Charge Amount |
81914.79 |
Total Medicare Allowed Amount |
41963.49 |
Total Medicare Payment Amount |
30241.13 |
Total Medicare Standardized Payment Amount |
29346.54 |
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 |
19 |
Number Of Medical Services |
518 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
81914.79 |
Total Medical Medicare Allowed Amount |
41963.49 |
Total Medical Medicare Payment Amount |
30241.13 |
Total Medical Medicare Standardized Payment Amount |
29346.54 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
264 |
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 |
223 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9393 |