National Provider Identifier [NPI]: |
1508855487 |
Last Name Of The Provider |
RAIMONDO |
First Name Of The Provider |
MASSIMO |
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 |
4500 SAN PABLO RD S |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322241865 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
799 |
Number Of Medicare Beneficiaries |
526 |
Total Submitted Charge Amount |
176644.2 |
Total Medicare Allowed Amount |
129021.13 |
Total Medicare Payment Amount |
99857.4 |
Total Medicare Standardized Payment Amount |
106398.44 |
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 |
59 |
Number Of Medical Services |
799 |
Number Of Medicare Beneficiaries With Medical Services |
526 |
Total Medical Submitted Charge Amount |
176644.2 |
Total Medical Medicare Allowed Amount |
129021.13 |
Total Medical Medicare Payment Amount |
99857.4 |
Total Medical Medicare Standardized Payment Amount |
106398.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
249 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
244 |
Number Of Non Hispanic White Beneficiaries |
463 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
483 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.4609 |