National Provider Identifier [NPI]: |
1134393028 |
Last Name Of The Provider |
BENEDETTO |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
X |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2221 GARRETT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DREXEL HILL |
Zip Code Of The Provider |
190261101 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
2154 |
Number Of Medicare Beneficiaries |
385 |
Total Submitted Charge Amount |
712510.57 |
Total Medicare Allowed Amount |
266524.26 |
Total Medicare Payment Amount |
206505.21 |
Total Medicare Standardized Payment Amount |
201840.26 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
26 |
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 |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3079 |