National Provider Identifier [NPI]: |
1770542888 |
Last Name Of The Provider |
BONOMO |
First Name Of The Provider |
GABRIELLA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY BLVD. |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
JUPITER |
Zip Code Of The Provider |
33458 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
3362 |
Number Of Medicare Beneficiaries |
875 |
Total Submitted Charge Amount |
522825 |
Total Medicare Allowed Amount |
370498.28 |
Total Medicare Payment Amount |
285650.47 |
Total Medicare Standardized Payment Amount |
274320.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
1190 |
Total Drug Medicare AllowedAmount |
1010.95 |
Total Drug Medicare PaymentAmount |
989.82 |
Total Drug Medicare Standardized Payment Amount |
989.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
3347 |
Number Of Medicare Beneficiaries With Medical Services |
875 |
Total Medical Submitted Charge Amount |
521635 |
Total Medical Medicare Allowed Amount |
369487.33 |
Total Medical Medicare Payment Amount |
284660.65 |
Total Medical Medicare Standardized Payment Amount |
273330.77 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
396 |
Number Of Beneficiaries Age 75 to 84 |
300 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
669 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
836 |
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 |
852 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1228 |