National Provider Identifier [NPI]: |
1396787768 |
Last Name Of The Provider |
TRILLING |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
181 N BELLE MEAD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAST SETAUKET |
Zip Code Of The Provider |
117333495 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
285 |
Number Of Medicare Beneficiaries |
90 |
Total Submitted Charge Amount |
46671 |
Total Medicare Allowed Amount |
27400.06 |
Total Medicare Payment Amount |
18468.73 |
Total Medicare Standardized Payment Amount |
16145.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
27 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
961 |
Total Drug Medicare AllowedAmount |
600.49 |
Total Drug Medicare PaymentAmount |
588.01 |
Total Drug Medicare Standardized Payment Amount |
588.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
258 |
Number Of Medicare Beneficiaries With Medical Services |
90 |
Total Medical Submitted Charge Amount |
45710 |
Total Medical Medicare Allowed Amount |
26799.57 |
Total Medical Medicare Payment Amount |
17880.72 |
Total Medical Medicare Standardized Payment Amount |
15557.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3935 |