National Provider Identifier [NPI]: |
1295735678 |
Last Name Of The Provider |
MANJONEY |
First Name Of The Provider |
DELIA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2720 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRIDGEPORT |
Zip Code Of The Provider |
066065308 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
2077 |
Number Of Medicare Beneficiaries |
953 |
Total Submitted Charge Amount |
613371 |
Total Medicare Allowed Amount |
289074.03 |
Total Medicare Payment Amount |
207604.59 |
Total Medicare Standardized Payment Amount |
191766.64 |
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 |
48 |
Number Of Medical Services |
2077 |
Number Of Medicare Beneficiaries With Medical Services |
953 |
Total Medical Submitted Charge Amount |
613371 |
Total Medical Medicare Allowed Amount |
289074.03 |
Total Medical Medicare Payment Amount |
207604.59 |
Total Medical Medicare Standardized Payment Amount |
191766.64 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
330 |
Number Of Beneficiaries Age 75 to 84 |
353 |
Number Of Beneficiaries Age Greater 84 |
232 |
Number Of Female Beneficiaries |
597 |
Number Of Male Beneficiaries |
356 |
Number Of Non Hispanic White Beneficiaries |
824 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
830 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1601 |