National Provider Identifier [NPI]: |
1083839724 |
Last Name Of The Provider |
PIERRE |
First Name Of The Provider |
EDECK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
465 SOUTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MORRISTOWN |
Zip Code Of The Provider |
079606442 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1789 |
Number Of Medicare Beneficiaries |
946 |
Total Submitted Charge Amount |
475955 |
Total Medicare Allowed Amount |
200852.38 |
Total Medicare Payment Amount |
156940.5 |
Total Medicare Standardized Payment Amount |
145828.6 |
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 |
19 |
Number Of Medical Services |
1789 |
Number Of Medicare Beneficiaries With Medical Services |
946 |
Total Medical Submitted Charge Amount |
475955 |
Total Medical Medicare Allowed Amount |
200852.38 |
Total Medical Medicare Payment Amount |
156940.5 |
Total Medical Medicare Standardized Payment Amount |
145828.6 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
325 |
Number Of Beneficiaries Age Greater 84 |
315 |
Number Of Female Beneficiaries |
529 |
Number Of Male Beneficiaries |
417 |
Number Of Non Hispanic White Beneficiaries |
851 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
802 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.0162 |