National Provider Identifier [NPI]: |
1053358325 |
Last Name Of The Provider |
SILICIANO |
First Name Of The Provider |
DEANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
640 JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT PAUL |
Zip Code Of The Provider |
551012502 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
327 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
758647.2 |
Total Medicare Allowed Amount |
53153.86 |
Total Medicare Payment Amount |
41634.21 |
Total Medicare Standardized Payment Amount |
44059.18 |
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 |
83 |
Number Of Medical Services |
327 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
758647.2 |
Total Medical Medicare Allowed Amount |
53153.86 |
Total Medical Medicare Payment Amount |
41634.21 |
Total Medical Medicare Standardized Payment Amount |
44059.18 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
226 |
Number Of Black or African American Beneficiaries |
17 |
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 |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6319 |