National Provider Identifier [NPI]: |
1669528311 |
Last Name Of The Provider |
SILVA |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1275 SUMMER ST |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
STAMFORD |
Zip Code Of The Provider |
069055359 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2359 |
Number Of Medicare Beneficiaries |
498 |
Total Submitted Charge Amount |
280610 |
Total Medicare Allowed Amount |
155936.55 |
Total Medicare Payment Amount |
113034.16 |
Total Medicare Standardized Payment Amount |
105191.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
109 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
4560 |
Total Drug Medicare AllowedAmount |
1277.17 |
Total Drug Medicare PaymentAmount |
1245.26 |
Total Drug Medicare Standardized Payment Amount |
1245.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
2250 |
Number Of Medicare Beneficiaries With Medical Services |
498 |
Total Medical Submitted Charge Amount |
276050 |
Total Medical Medicare Allowed Amount |
154659.38 |
Total Medical Medicare Payment Amount |
111788.9 |
Total Medical Medicare Standardized Payment Amount |
103946.25 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
403 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2024 |