National Provider Identifier [NPI]: |
1205989241 |
Last Name Of The Provider |
PRETTELT |
First Name Of The Provider |
ADOLFO |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
123 EGG HARBOR RD STE 604 |
Street Address 2 Of The Provider |
TOWER COMMONS BLDG 600 |
City Of The Provider |
SEWELL |
Zip Code Of The Provider |
080809408 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
798 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
109939 |
Total Medicare Allowed Amount |
72617.83 |
Total Medicare Payment Amount |
52731.59 |
Total Medicare Standardized Payment Amount |
49479.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
3256 |
Total Drug Medicare AllowedAmount |
1805.05 |
Total Drug Medicare PaymentAmount |
1767.28 |
Total Drug Medicare Standardized Payment Amount |
1767.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
736 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
106683 |
Total Medical Medicare Allowed Amount |
70812.78 |
Total Medical Medicare Payment Amount |
50964.31 |
Total Medical Medicare Standardized Payment Amount |
47711.87 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
110 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1897 |