National Provider Identifier [NPI]: |
1588618730 |
Last Name Of The Provider |
MAZZOTTA |
First Name Of The Provider |
FRANK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1638 W PASSYUNK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191453846 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2053 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
272460 |
Total Medicare Allowed Amount |
145896.9 |
Total Medicare Payment Amount |
107285.03 |
Total Medicare Standardized Payment Amount |
104116.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
120 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
30915 |
Total Drug Medicare AllowedAmount |
4769.29 |
Total Drug Medicare PaymentAmount |
4557.85 |
Total Drug Medicare Standardized Payment Amount |
4557.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1933 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
241545 |
Total Medical Medicare Allowed Amount |
141127.61 |
Total Medical Medicare Payment Amount |
102727.18 |
Total Medical Medicare Standardized Payment Amount |
99558.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5692 |