National Provider Identifier [NPI]: |
1467501114 |
Last Name Of The Provider |
POMILLA |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 HOSPITAL RD STE 310 |
Street Address 2 Of The Provider |
|
City Of The Provider |
PRINCE FREDERICK |
Zip Code Of The Provider |
206784041 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
5181 |
Number Of Medicare Beneficiaries |
430 |
Total Submitted Charge Amount |
291607 |
Total Medicare Allowed Amount |
193491.02 |
Total Medicare Payment Amount |
149470.45 |
Total Medicare Standardized Payment Amount |
149243.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
249 |
Number Of Medicare Beneficiaries With Drug Services |
172 |
Total Drug Submitted ChargeAmount |
13212 |
Total Drug Medicare AllowedAmount |
9942.71 |
Total Drug Medicare PaymentAmount |
9710.75 |
Total Drug Medicare Standardized Payment Amount |
9710.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
4932 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
278395 |
Total Medical Medicare Allowed Amount |
183548.31 |
Total Medical Medicare Payment Amount |
139759.7 |
Total Medical Medicare Standardized Payment Amount |
139532.9 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
351 |
Number Of Black or African American Beneficiaries |
67 |
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 |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7291 |