National Provider Identifier [NPI]: |
1457370785 |
Last Name Of The Provider |
RIVADENEIRA |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
48 ROUTE 25A |
Street Address 2 Of The Provider |
SUITE 007 |
City Of The Provider |
SMITHTOWN |
Zip Code Of The Provider |
117871431 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
895 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
1583132.5 |
Total Medicare Allowed Amount |
323294.24 |
Total Medicare Payment Amount |
250709.49 |
Total Medicare Standardized Payment Amount |
200756.17 |
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 |
91 |
Number Of Medical Services |
895 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
1583132.5 |
Total Medical Medicare Allowed Amount |
323294.24 |
Total Medical Medicare Payment Amount |
250709.49 |
Total Medical Medicare Standardized Payment Amount |
200756.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2469 |