National Provider Identifier [NPI]: |
1407874605 |
Last Name Of The Provider |
DELL'AGLIO |
First Name Of The Provider |
DAMON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 PEACHTREE ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303082247 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
663 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
682807 |
Total Medicare Allowed Amount |
103996.76 |
Total Medicare Payment Amount |
78990.03 |
Total Medicare Standardized Payment Amount |
79115.72 |
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 |
20 |
Number Of Medical Services |
663 |
Number Of Medicare Beneficiaries With Medical Services |
576 |
Total Medical Submitted Charge Amount |
682807 |
Total Medical Medicare Allowed Amount |
103996.76 |
Total Medical Medicare Payment Amount |
78990.03 |
Total Medical Medicare Standardized Payment Amount |
79115.72 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
214 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
337 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
329 |
Number Of Black or African American Beneficiaries |
229 |
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 |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
218 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.5603 |