National Provider Identifier [NPI]: |
1467453746 |
Last Name Of The Provider |
VIGESAA |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 NEAL ZICK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLARD |
Zip Code Of The Provider |
448909287 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
3367 |
Number Of Medicare Beneficiaries |
775 |
Total Submitted Charge Amount |
394672 |
Total Medicare Allowed Amount |
253432.03 |
Total Medicare Payment Amount |
189203.05 |
Total Medicare Standardized Payment Amount |
197391.23 |
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 |
55 |
Number Of Medical Services |
3367 |
Number Of Medicare Beneficiaries With Medical Services |
775 |
Total Medical Submitted Charge Amount |
394672 |
Total Medical Medicare Allowed Amount |
253432.03 |
Total Medical Medicare Payment Amount |
189203.05 |
Total Medical Medicare Standardized Payment Amount |
197391.23 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
307 |
Number Of Beneficiaries Age 75 to 84 |
297 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
397 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
753 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
676 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3831 |