National Provider Identifier [NPI]: |
1821054362 |
Last Name Of The Provider |
TARGINO |
First Name Of The Provider |
MARCELO |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 ALUMNI DR |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
EXETER |
Zip Code Of The Provider |
038332128 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
119 |
Number Of Medicare Beneficiaries |
78 |
Total Submitted Charge Amount |
19241 |
Total Medicare Allowed Amount |
13000.61 |
Total Medicare Payment Amount |
10191.92 |
Total Medicare Standardized Payment Amount |
10025.94 |
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 |
119 |
Number Of Medicare Beneficiaries With Medical Services |
78 |
Total Medical Submitted Charge Amount |
19241 |
Total Medical Medicare Allowed Amount |
13000.61 |
Total Medical Medicare Payment Amount |
10191.92 |
Total Medical Medicare Standardized Payment Amount |
10025.94 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
34 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
|
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 |
40 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3503 |