National Provider Identifier [NPI]: |
1548421704 |
Last Name Of The Provider |
MCCONNELL |
First Name Of The Provider |
DARCY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
31 OAK ST |
Street Address 2 Of The Provider |
SUITE 3 |
City Of The Provider |
PATCHOGUE |
Zip Code Of The Provider |
117722841 |
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 |
24 |
Number Of Services |
539 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
73973 |
Total Medicare Allowed Amount |
42488.74 |
Total Medicare Payment Amount |
30389.5 |
Total Medicare Standardized Payment Amount |
26476.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
49 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1268 |
Total Drug Medicare AllowedAmount |
630.86 |
Total Drug Medicare PaymentAmount |
610.57 |
Total Drug Medicare Standardized Payment Amount |
610.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
490 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
72705 |
Total Medical Medicare Allowed Amount |
41857.88 |
Total Medical Medicare Payment Amount |
29778.93 |
Total Medical Medicare Standardized Payment Amount |
25865.7 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
94 |
Number Of Black or African American Beneficiaries |
11 |
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 |
48 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3204 |