National Provider Identifier [NPI]: |
1144244682 |
Last Name Of The Provider |
DAMORE |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2430 SAMARITAN DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN JOSE |
Zip Code Of The Provider |
95124 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
1011 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
204292.61 |
Total Medicare Allowed Amount |
108010.12 |
Total Medicare Payment Amount |
83405.41 |
Total Medicare Standardized Payment Amount |
71574.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
294 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
8700.72 |
Total Drug Medicare AllowedAmount |
5635.1 |
Total Drug Medicare PaymentAmount |
4417.89 |
Total Drug Medicare Standardized Payment Amount |
4417.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
717 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
195591.89 |
Total Medical Medicare Allowed Amount |
102375.02 |
Total Medical Medicare Payment Amount |
78987.52 |
Total Medical Medicare Standardized Payment Amount |
67156.92 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
161 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8692 |