National Provider Identifier [NPI]: |
1558325845 |
Last Name Of The Provider |
CAPALLO |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11806 MERCY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314191714 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
694 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
968738 |
Total Medicare Allowed Amount |
350136.38 |
Total Medicare Payment Amount |
272062.08 |
Total Medicare Standardized Payment Amount |
285870.79 |
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 |
82 |
Number Of Medical Services |
694 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
968738 |
Total Medical Medicare Allowed Amount |
350136.38 |
Total Medical Medicare Payment Amount |
272062.08 |
Total Medical Medicare Standardized Payment Amount |
285870.79 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
204 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6276 |