National Provider Identifier [NPI]: |
1952355794 |
Last Name Of The Provider |
CALL |
First Name Of The Provider |
ANDREW |
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 |
35 GLEN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALFRED |
Zip Code Of The Provider |
148021025 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
2648 |
Number Of Medicare Beneficiaries |
517 |
Total Submitted Charge Amount |
216923.84 |
Total Medicare Allowed Amount |
164757.51 |
Total Medicare Payment Amount |
112396.73 |
Total Medicare Standardized Payment Amount |
118980.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
212 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
5945 |
Total Drug Medicare AllowedAmount |
4110.89 |
Total Drug Medicare PaymentAmount |
4016.8 |
Total Drug Medicare Standardized Payment Amount |
4016.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2436 |
Number Of Medicare Beneficiaries With Medical Services |
517 |
Total Medical Submitted Charge Amount |
210978.84 |
Total Medical Medicare Allowed Amount |
160646.62 |
Total Medical Medicare Payment Amount |
108379.93 |
Total Medical Medicare Standardized Payment Amount |
114963.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
224 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
498 |
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 |
436 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9777 |