National Provider Identifier [NPI]: |
1598751414 |
Last Name Of The Provider |
WROBLESKI |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
827 N MAIN ST |
Street Address 2 Of The Provider |
SUITE 3 |
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029045751 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
559 |
Number Of Medicare Beneficiaries |
257 |
Total Submitted Charge Amount |
174590 |
Total Medicare Allowed Amount |
78153.44 |
Total Medicare Payment Amount |
58619.16 |
Total Medicare Standardized Payment Amount |
58804.49 |
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 |
16 |
Number Of Medical Services |
559 |
Number Of Medicare Beneficiaries With Medical Services |
257 |
Total Medical Submitted Charge Amount |
174590 |
Total Medical Medicare Allowed Amount |
78153.44 |
Total Medical Medicare Payment Amount |
58619.16 |
Total Medical Medicare Standardized Payment Amount |
58804.49 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
245 |
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 |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9577 |