National Provider Identifier [NPI]: |
1841455227 |
Last Name Of The Provider |
PORAC |
First Name Of The Provider |
MATTHEW |
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 |
24 HOSPITAL AVE |
Street Address 2 Of The Provider |
DANBURY HOSPITAL - HOSPITALIST PROGRAM |
City Of The Provider |
DANBURY |
Zip Code Of The Provider |
068106099 |
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 |
16 |
Number Of Services |
1554 |
Number Of Medicare Beneficiaries |
634 |
Total Submitted Charge Amount |
299107 |
Total Medicare Allowed Amount |
171759.26 |
Total Medicare Payment Amount |
131682.85 |
Total Medicare Standardized Payment Amount |
126312.98 |
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 |
16 |
Number Of Medical Services |
1554 |
Number Of Medicare Beneficiaries With Medical Services |
634 |
Total Medical Submitted Charge Amount |
299107 |
Total Medical Medicare Allowed Amount |
171759.26 |
Total Medical Medicare Payment Amount |
131682.85 |
Total Medical Medicare Standardized Payment Amount |
126312.98 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
206 |
Number Of Female Beneficiaries |
344 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
568 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
439 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
195 |
Percent Of With Atrial Fibrillation |
37 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2112 |