National Provider Identifier [NPI]: |
1619924339 |
Last Name Of The Provider |
MUSICANTE |
First Name Of The Provider |
SERGIO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6019 WALNUT GROVE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381202113 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
665 |
Number Of Medicare Beneficiaries |
622 |
Total Submitted Charge Amount |
619375 |
Total Medicare Allowed Amount |
104916.72 |
Total Medicare Payment Amount |
81621.48 |
Total Medicare Standardized Payment Amount |
85706.07 |
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 |
14 |
Number Of Medical Services |
665 |
Number Of Medicare Beneficiaries With Medical Services |
622 |
Total Medical Submitted Charge Amount |
619375 |
Total Medical Medicare Allowed Amount |
104916.72 |
Total Medical Medicare Payment Amount |
81621.48 |
Total Medical Medicare Standardized Payment Amount |
85706.07 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
128 |
Number Of Female Beneficiaries |
399 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
411 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
430 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
192 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.6876 |