National Provider Identifier [NPI]: |
1992724306 |
Last Name Of The Provider |
DIMARCO |
First Name Of The Provider |
CARLO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4000 STERRETTANIA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ERIE |
Zip Code Of The Provider |
165064125 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
196 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
38458 |
Total Medicare Allowed Amount |
30400.02 |
Total Medicare Payment Amount |
20286.89 |
Total Medicare Standardized Payment Amount |
21130.74 |
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 |
18 |
Number Of Medical Services |
196 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
38458 |
Total Medical Medicare Allowed Amount |
30400.02 |
Total Medical Medicare Payment Amount |
20286.89 |
Total Medical Medicare Standardized Payment Amount |
21130.74 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
19 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4258 |