National Provider Identifier [NPI]: |
1386810802 |
Last Name Of The Provider |
BALLARINO |
First Name Of The Provider |
GUILLERMO |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24 HOSPITAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANBURY |
Zip Code Of The Provider |
068106099 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
2736 |
Number Of Medicare Beneficiaries |
946 |
Total Submitted Charge Amount |
577749 |
Total Medicare Allowed Amount |
265847.86 |
Total Medicare Payment Amount |
202950.61 |
Total Medicare Standardized Payment Amount |
191938.98 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
329 |
Number Of Beneficiaries Age 75 to 84 |
349 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
534 |
Number Of Male Beneficiaries |
412 |
Number Of Non Hispanic White Beneficiaries |
857 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
660 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
286 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
32 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
54 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.037 |