National Provider Identifier [NPI]: |
1760411276 |
Last Name Of The Provider |
ACOSTA |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 6TH ST S |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337014814 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
842 |
Number Of Medicare Beneficiaries |
537 |
Total Submitted Charge Amount |
540196 |
Total Medicare Allowed Amount |
96067.97 |
Total Medicare Payment Amount |
72783.94 |
Total Medicare Standardized Payment Amount |
71413.64 |
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 |
25 |
Number Of Medical Services |
842 |
Number Of Medicare Beneficiaries With Medical Services |
537 |
Total Medical Submitted Charge Amount |
540196 |
Total Medical Medicare Allowed Amount |
96067.97 |
Total Medical Medicare Payment Amount |
72783.94 |
Total Medical Medicare Standardized Payment Amount |
71413.64 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
344 |
Number Of Black or African American Beneficiaries |
169 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
293 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.5806 |