National Provider Identifier [NPI]: |
1912081019 |
Last Name Of The Provider |
DIAMOND |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9105 FRANKLIN SQUARE DRIVE |
Street Address 2 Of The Provider |
SUITE 308 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
21237 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
902 |
Number Of Medicare Beneficiaries |
491 |
Total Submitted Charge Amount |
389995 |
Total Medicare Allowed Amount |
143587.57 |
Total Medicare Payment Amount |
109341.9 |
Total Medicare Standardized Payment Amount |
106424.37 |
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 |
19 |
Number Of Medical Services |
902 |
Number Of Medicare Beneficiaries With Medical Services |
491 |
Total Medical Submitted Charge Amount |
389995 |
Total Medical Medicare Allowed Amount |
143587.57 |
Total Medical Medicare Payment Amount |
109341.9 |
Total Medical Medicare Standardized Payment Amount |
106424.37 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
255 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
457 |
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 |
448 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0472 |