National Provider Identifier [NPI]: |
1679577019 |
Last Name Of The Provider |
PISARELLO |
First Name Of The Provider |
CAROL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4444 KALAMAZOO AVE SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENTWOOD |
Zip Code Of The Provider |
495084600 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
4346 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
225572 |
Total Medicare Allowed Amount |
150083.9 |
Total Medicare Payment Amount |
104623.84 |
Total Medicare Standardized Payment Amount |
110927.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
1929 |
Number Of Medicare Beneficiaries With Drug Services |
147 |
Total Drug Submitted ChargeAmount |
50977 |
Total Drug Medicare AllowedAmount |
30687.33 |
Total Drug Medicare PaymentAmount |
24612.56 |
Total Drug Medicare Standardized Payment Amount |
24612.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2417 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
174595 |
Total Medical Medicare Allowed Amount |
119396.57 |
Total Medical Medicare Payment Amount |
80011.28 |
Total Medical Medicare Standardized Payment Amount |
86315.37 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
214 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
329 |
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 |
338 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1585 |