National Provider Identifier [NPI]: |
1982770764 |
Last Name Of The Provider |
MANNARELLI |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
135 ATWOOD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CRANSTON |
Zip Code Of The Provider |
029204131 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1123 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
162460 |
Total Medicare Allowed Amount |
105649 |
Total Medicare Payment Amount |
76432.27 |
Total Medicare Standardized Payment Amount |
74102.95 |
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 |
69 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4409 |