National Provider Identifier [NPI]: |
1528179991 |
Last Name Of The Provider |
DENUCCIO |
First Name Of The Provider |
MARC |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15357 FARMINGTON RD. |
Street Address 2 Of The Provider |
STE. 2 |
City Of The Provider |
LIVONIA |
Zip Code Of The Provider |
48154 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
5335 |
Number Of Medicare Beneficiaries |
335 |
Total Submitted Charge Amount |
660045 |
Total Medicare Allowed Amount |
456097.66 |
Total Medicare Payment Amount |
355152.64 |
Total Medicare Standardized Payment Amount |
345041 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
103 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
4525 |
Total Drug Medicare AllowedAmount |
2760.6 |
Total Drug Medicare PaymentAmount |
2705.51 |
Total Drug Medicare Standardized Payment Amount |
2705.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
5232 |
Number Of Medicare Beneficiaries With Medical Services |
335 |
Total Medical Submitted Charge Amount |
655520 |
Total Medical Medicare Allowed Amount |
453337.06 |
Total Medical Medicare Payment Amount |
352447.13 |
Total Medical Medicare Standardized Payment Amount |
342335.49 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
240 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
41 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
61 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.3382 |