National Provider Identifier [NPI]: |
1427036433 |
Last Name Of The Provider |
TOMAK |
First Name Of The Provider |
SANDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2408 WHITNEY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HAMDEN |
Zip Code Of The Provider |
065183209 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
2135 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
313714 |
Total Medicare Allowed Amount |
126150.37 |
Total Medicare Payment Amount |
94867.65 |
Total Medicare Standardized Payment Amount |
91139.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
110 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
2638 |
Total Drug Medicare AllowedAmount |
1245.35 |
Total Drug Medicare PaymentAmount |
954.26 |
Total Drug Medicare Standardized Payment Amount |
954.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
2025 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
311076 |
Total Medical Medicare Allowed Amount |
124905.02 |
Total Medical Medicare Payment Amount |
93913.39 |
Total Medical Medicare Standardized Payment Amount |
90185.36 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
232 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.011 |