National Provider Identifier [NPI]: |
1649257304 |
Last Name Of The Provider |
YACOBUCCI |
First Name Of The Provider |
GERALD |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 E HIGHLAND AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850164872 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
3012 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
426752.9 |
Total Medicare Allowed Amount |
94081.59 |
Total Medicare Payment Amount |
69923.64 |
Total Medicare Standardized Payment Amount |
70619.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2244 |
Number Of Medicare Beneficiaries With Drug Services |
131 |
Total Drug Submitted ChargeAmount |
183782 |
Total Drug Medicare AllowedAmount |
23157.67 |
Total Drug Medicare PaymentAmount |
17780.51 |
Total Drug Medicare Standardized Payment Amount |
17780.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
768 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
242970.9 |
Total Medical Medicare Allowed Amount |
70923.92 |
Total Medical Medicare Payment Amount |
52143.13 |
Total Medical Medicare Standardized Payment Amount |
52838.7 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
190 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6794 |