National Provider Identifier [NPI]: |
1013985084 |
Last Name Of The Provider |
CARDOSI |
First Name Of The Provider |
PAUL |
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 |
1700 E 19TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
THE DALLES |
Zip Code Of The Provider |
970583317 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
601 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
188734 |
Total Medicare Allowed Amount |
33035.38 |
Total Medicare Payment Amount |
24105.15 |
Total Medicare Standardized Payment Amount |
25267.21 |
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 |
9 |
Number Of Medical Services |
601 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
188734 |
Total Medical Medicare Allowed Amount |
33035.38 |
Total Medical Medicare Payment Amount |
24105.15 |
Total Medical Medicare Standardized Payment Amount |
25267.21 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
150 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
301 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.982 |