National Provider Identifier [NPI]: |
1306916093 |
Last Name Of The Provider |
LAFONTANT |
First Name Of The Provider |
GILBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
60 TOWNSHIP LINE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELKINS PARK |
Zip Code Of The Provider |
190272220 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
343 |
Number Of Medicare Beneficiaries |
311 |
Total Submitted Charge Amount |
98845 |
Total Medicare Allowed Amount |
47850.2 |
Total Medicare Payment Amount |
37352.04 |
Total Medicare Standardized Payment Amount |
35352.03 |
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 |
343 |
Number Of Medicare Beneficiaries With Medical Services |
311 |
Total Medical Submitted Charge Amount |
98845 |
Total Medical Medicare Allowed Amount |
47850.2 |
Total Medical Medicare Payment Amount |
37352.04 |
Total Medical Medicare Standardized Payment Amount |
35352.03 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
110 |
Number Of Black or African American Beneficiaries |
180 |
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
39 |
Average HCC Risk Score Of Beneficiaries |
2.4823 |