National Provider Identifier [NPI]: |
1558322917 |
Last Name Of The Provider |
SICILIANO |
First Name Of The Provider |
GERARD |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3999 DUTCHMANS LN |
Street Address 2 Of The Provider |
SUITE 7B |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402074729 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1856 |
Number Of Medicare Beneficiaries |
801 |
Total Submitted Charge Amount |
455131 |
Total Medicare Allowed Amount |
226746.23 |
Total Medicare Payment Amount |
170181.58 |
Total Medicare Standardized Payment Amount |
186211.69 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
330 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
510 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
719 |
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 |
650 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5709 |