National Provider Identifier [NPI]: |
1255356184 |
Last Name Of The Provider |
SABETTA |
First Name Of The Provider |
JULIA |
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 |
4 DEARFIELD DR |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
GREENWICH |
Zip Code Of The Provider |
068315351 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
829 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
139644.41 |
Total Medicare Allowed Amount |
119746.57 |
Total Medicare Payment Amount |
92812.58 |
Total Medicare Standardized Payment Amount |
92551.9 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
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Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
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Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
11 |
Percent Of With Diabetes |
11 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8531 |