National Provider Identifier [NPI]: |
1770569527 |
Last Name Of The Provider |
PAGE |
First Name Of The Provider |
RALPH |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1026 FLORIDA AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKLEDGE |
Zip Code Of The Provider |
329552132 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
21794 |
Number Of Medicare Beneficiaries |
707 |
Total Submitted Charge Amount |
1288315 |
Total Medicare Allowed Amount |
791845.55 |
Total Medicare Payment Amount |
617267.46 |
Total Medicare Standardized Payment Amount |
608660.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1259 |
Number Of Medicare Beneficiaries With Drug Services |
297 |
Total Drug Submitted ChargeAmount |
14520 |
Total Drug Medicare AllowedAmount |
5079.44 |
Total Drug Medicare PaymentAmount |
4503.92 |
Total Drug Medicare Standardized Payment Amount |
4503.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
20535 |
Number Of Medicare Beneficiaries With Medical Services |
707 |
Total Medical Submitted Charge Amount |
1273795 |
Total Medical Medicare Allowed Amount |
786766.11 |
Total Medical Medicare Payment Amount |
612763.54 |
Total Medical Medicare Standardized Payment Amount |
604156.38 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
220 |
Number Of Beneficiaries Age 65 to 74 |
197 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
332 |
Number Of Non Hispanic White Beneficiaries |
528 |
Number Of Black or African American Beneficiaries |
148 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
382 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
325 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
70 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0613 |