National Provider Identifier [NPI]: |
1023089315 |
Last Name Of The Provider |
ESTIME |
First Name Of The Provider |
PIERRE |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
46 ALBION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRIDGEPORT |
Zip Code Of The Provider |
066052602 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
342 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
74263.05 |
Total Medicare Allowed Amount |
30182.07 |
Total Medicare Payment Amount |
21584.46 |
Total Medicare Standardized Payment Amount |
20228.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
295 |
Total Drug Medicare AllowedAmount |
43.1 |
Total Drug Medicare PaymentAmount |
41.53 |
Total Drug Medicare Standardized Payment Amount |
41.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
328 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
73968.05 |
Total Medical Medicare Allowed Amount |
30138.97 |
Total Medical Medicare Payment Amount |
21542.93 |
Total Medical Medicare Standardized Payment Amount |
20187.39 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0947 |