National Provider Identifier [NPI]: |
1265641104 |
Last Name Of The Provider |
CANCEDDA |
First Name Of The Provider |
CORRADO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD, PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
75 FRANCIS ST |
Street Address 2 Of The Provider |
DIVISION OF GLOBAL HEALTH EQUITY |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021156110 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
322 |
Number Of Medicare Beneficiaries |
111 |
Total Submitted Charge Amount |
116806 |
Total Medicare Allowed Amount |
35366.96 |
Total Medicare Payment Amount |
26803.18 |
Total Medicare Standardized Payment Amount |
26034.72 |
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 |
8 |
Number Of Medical Services |
322 |
Number Of Medicare Beneficiaries With Medical Services |
111 |
Total Medical Submitted Charge Amount |
116806 |
Total Medical Medicare Allowed Amount |
35366.96 |
Total Medical Medicare Payment Amount |
26803.18 |
Total Medical Medicare Standardized Payment Amount |
26034.72 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
23 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2133 |