National Provider Identifier [NPI]: |
1144220567 |
Last Name Of The Provider |
MARTINO |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
149 N VINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HAZLETON |
Zip Code Of The Provider |
182015852 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
5954 |
Number Of Medicare Beneficiaries |
947 |
Total Submitted Charge Amount |
679043 |
Total Medicare Allowed Amount |
460835.32 |
Total Medicare Payment Amount |
354651.63 |
Total Medicare Standardized Payment Amount |
366495.29 |
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 |
19 |
Number Of Medical Services |
5954 |
Number Of Medicare Beneficiaries With Medical Services |
947 |
Total Medical Submitted Charge Amount |
679043 |
Total Medical Medicare Allowed Amount |
460835.32 |
Total Medical Medicare Payment Amount |
354651.63 |
Total Medical Medicare Standardized Payment Amount |
366495.29 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
311 |
Number Of Beneficiaries Age 75 to 84 |
273 |
Number Of Beneficiaries Age Greater 84 |
215 |
Number Of Female Beneficiaries |
528 |
Number Of Male Beneficiaries |
419 |
Number Of Non Hispanic White Beneficiaries |
905 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
645 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
302 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
66 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2707 |