National Provider Identifier [NPI]: |
1164514386 |
Last Name Of The Provider |
BERTOLI |
First Name Of The Provider |
LUIGI |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2022 BROOKWOOD MEDICAL CTR DR |
Street Address 2 Of The Provider |
SUITE G105 |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352096808 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
97546.5 |
Number Of Medicare Beneficiaries |
396 |
Total Submitted Charge Amount |
5895601 |
Total Medicare Allowed Amount |
2725227.4 |
Total Medicare Payment Amount |
2106794.99 |
Total Medicare Standardized Payment Amount |
2103247.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
55 |
Number Of Drug Services |
87327.5 |
Number Of Medicare Beneficiaries With Drug Services |
198 |
Total Drug Submitted ChargeAmount |
5122810 |
Total Drug Medicare AllowedAmount |
2353331.14 |
Total Drug Medicare PaymentAmount |
1818507.67 |
Total Drug Medicare Standardized Payment Amount |
1818507.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
10219 |
Number Of Medicare Beneficiaries With Medical Services |
395 |
Total Medical Submitted Charge Amount |
772791 |
Total Medical Medicare Allowed Amount |
371896.26 |
Total Medical Medicare Payment Amount |
288287.32 |
Total Medical Medicare Standardized Payment Amount |
284739.38 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
273 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
344 |
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 |
372 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7444 |