National Provider Identifier [NPI]: |
1194896480 |
Last Name Of The Provider |
VANZUIDEN |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
33 STANIFORD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029053105 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1155 |
Number Of Medicare Beneficiaries |
338 |
Total Submitted Charge Amount |
401206 |
Total Medicare Allowed Amount |
116155.33 |
Total Medicare Payment Amount |
87348.44 |
Total Medicare Standardized Payment Amount |
79987.85 |
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 |
33 |
Number Of Medical Services |
1155 |
Number Of Medicare Beneficiaries With Medical Services |
338 |
Total Medical Submitted Charge Amount |
401206 |
Total Medical Medicare Allowed Amount |
116155.33 |
Total Medical Medicare Payment Amount |
87348.44 |
Total Medical Medicare Standardized Payment Amount |
79987.85 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
269 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.138 |