National Provider Identifier [NPI]: |
1699752568 |
Last Name Of The Provider |
MARZO |
First Name Of The Provider |
SAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2160 S 1ST AVE |
Street Address 2 Of The Provider |
MAGUIRE CENTER 1870 |
City Of The Provider |
MAYWOOD |
Zip Code Of The Provider |
601533328 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1213 |
Number Of Medicare Beneficiaries |
456 |
Total Submitted Charge Amount |
639362 |
Total Medicare Allowed Amount |
145602.77 |
Total Medicare Payment Amount |
109513.45 |
Total Medicare Standardized Payment Amount |
100572.21 |
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 |
39 |
Number Of Medical Services |
1213 |
Number Of Medicare Beneficiaries With Medical Services |
456 |
Total Medical Submitted Charge Amount |
639362 |
Total Medical Medicare Allowed Amount |
145602.77 |
Total Medical Medicare Payment Amount |
109513.45 |
Total Medical Medicare Standardized Payment Amount |
100572.21 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
387 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1425 |