National Provider Identifier [NPI]: |
1336126846 |
Last Name Of The Provider |
SALVIETTI |
First Name Of The Provider |
RALPH |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 RETREAT AVE |
Street Address 2 Of The Provider |
DONNELLY BUILDING |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
061063309 |
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 |
17 |
Number Of Services |
453 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
68853 |
Total Medicare Allowed Amount |
40500.2 |
Total Medicare Payment Amount |
30770.68 |
Total Medicare Standardized Payment Amount |
29142.97 |
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 |
17 |
Number Of Medical Services |
453 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
68853 |
Total Medical Medicare Allowed Amount |
40500.2 |
Total Medical Medicare Payment Amount |
30770.68 |
Total Medical Medicare Standardized Payment Amount |
29142.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
116 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4687 |