National Provider Identifier [NPI]: |
1366482846 |
Last Name Of The Provider |
SAVIN |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
134 PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
065115409 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1741 |
Number Of Medicare Beneficiaries |
647 |
Total Submitted Charge Amount |
267864.72 |
Total Medicare Allowed Amount |
154391.7 |
Total Medicare Payment Amount |
111579.19 |
Total Medicare Standardized Payment Amount |
104471.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
214 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
7020 |
Total Drug Medicare AllowedAmount |
6889.63 |
Total Drug Medicare PaymentAmount |
5194.47 |
Total Drug Medicare Standardized Payment Amount |
5194.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1527 |
Number Of Medicare Beneficiaries With Medical Services |
647 |
Total Medical Submitted Charge Amount |
260844.72 |
Total Medical Medicare Allowed Amount |
147502.07 |
Total Medical Medicare Payment Amount |
106384.72 |
Total Medical Medicare Standardized Payment Amount |
99277.01 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
397 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
540 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
491 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.125 |