National Provider Identifier [NPI]: |
1629037833 |
Last Name Of The Provider |
MASSIMIANO |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2921 TELESTAR CT |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
FALLS CHURCH |
Zip Code Of The Provider |
220421205 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
321 |
Number Of Medicare Beneficiaries |
121 |
Total Submitted Charge Amount |
730779 |
Total Medicare Allowed Amount |
260806.93 |
Total Medicare Payment Amount |
204040.35 |
Total Medicare Standardized Payment Amount |
184574.19 |
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 |
35 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
121 |
Total Medical Submitted Charge Amount |
730779 |
Total Medical Medicare Allowed Amount |
260806.93 |
Total Medical Medicare Payment Amount |
204040.35 |
Total Medical Medicare Standardized Payment Amount |
184574.19 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
13 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.3172 |