National Provider Identifier [NPI]: |
1942241674 |
Last Name Of The Provider |
CUCCHIARA |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 CIVIC CENTER BLVD |
Street Address 2 Of The Provider |
2ND FLOOR, SOUTH PAVILION |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191045127 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
662 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
175763 |
Total Medicare Allowed Amount |
55423.8 |
Total Medicare Payment Amount |
43205.44 |
Total Medicare Standardized Payment Amount |
41172.1 |
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 |
24 |
Number Of Medical Services |
662 |
Number Of Medicare Beneficiaries With Medical Services |
291 |
Total Medical Submitted Charge Amount |
175763 |
Total Medical Medicare Allowed Amount |
55423.8 |
Total Medical Medicare Payment Amount |
43205.44 |
Total Medical Medicare Standardized Payment Amount |
41172.1 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
192 |
Number Of Black or African American Beneficiaries |
75 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
75 |
Average HCC Risk Score Of Beneficiaries |
1.9355 |