National Provider Identifier [NPI]: |
1376506048 |
Last Name Of The Provider |
CASANTA |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2323 9TH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337136832 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1009 |
Number Of Medicare Beneficiaries |
449 |
Total Submitted Charge Amount |
496502 |
Total Medicare Allowed Amount |
109581.87 |
Total Medicare Payment Amount |
83095.11 |
Total Medicare Standardized Payment Amount |
81914.01 |
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 |
30 |
Number Of Medical Services |
1009 |
Number Of Medicare Beneficiaries With Medical Services |
449 |
Total Medical Submitted Charge Amount |
496502 |
Total Medical Medicare Allowed Amount |
109581.87 |
Total Medical Medicare Payment Amount |
83095.11 |
Total Medical Medicare Standardized Payment Amount |
81914.01 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
404 |
Number Of Black or African American Beneficiaries |
32 |
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 |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0319 |