National Provider Identifier [NPI]: |
1730301524 |
Last Name Of The Provider |
MACCOTTA |
First Name Of The Provider |
LUIGI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
486 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
247155 |
Total Medicare Allowed Amount |
74576.5 |
Total Medicare Payment Amount |
56104.17 |
Total Medicare Standardized Payment Amount |
57150.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
486 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
247155 |
Total Medical Medicare Allowed Amount |
74576.5 |
Total Medical Medicare Payment Amount |
56104.17 |
Total Medical Medicare Standardized Payment Amount |
57150.93 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
31 |
Average HCC Risk Score Of Beneficiaries |
2.239 |