National Provider Identifier [NPI]: |
1619979804 |
Last Name Of The Provider |
PANTANO |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 CENTRAL STREET |
Street Address 2 Of The Provider |
4TH FLOOR |
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
01608 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1401 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
121822.49 |
Total Medicare Allowed Amount |
81287.94 |
Total Medicare Payment Amount |
65184.03 |
Total Medicare Standardized Payment Amount |
62926.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
357 |
Number Of Medicare Beneficiaries With Drug Services |
110 |
Total Drug Submitted ChargeAmount |
2434.49 |
Total Drug Medicare AllowedAmount |
1207.07 |
Total Drug Medicare PaymentAmount |
1099.99 |
Total Drug Medicare Standardized Payment Amount |
1099.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1044 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
119388 |
Total Medical Medicare Allowed Amount |
80080.87 |
Total Medical Medicare Payment Amount |
64084.04 |
Total Medical Medicare Standardized Payment Amount |
61826.21 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
302 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0223 |