National Provider Identifier [NPI]: |
1487646097 |
Last Name Of The Provider |
MIRABELLO |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3890 TAMPA RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
PALM HARBOR |
Zip Code Of The Provider |
346843676 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
4338 |
Number Of Medicare Beneficiaries |
585 |
Total Submitted Charge Amount |
1921512 |
Total Medicare Allowed Amount |
343344.67 |
Total Medicare Payment Amount |
258011.96 |
Total Medicare Standardized Payment Amount |
256395.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
882 |
Number Of Medicare Beneficiaries With Drug Services |
383 |
Total Drug Submitted ChargeAmount |
102191 |
Total Drug Medicare AllowedAmount |
33276.12 |
Total Drug Medicare PaymentAmount |
25986.77 |
Total Drug Medicare Standardized Payment Amount |
25986.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
3456 |
Number Of Medicare Beneficiaries With Medical Services |
585 |
Total Medical Submitted Charge Amount |
1819321 |
Total Medical Medicare Allowed Amount |
310068.55 |
Total Medical Medicare Payment Amount |
232025.19 |
Total Medical Medicare Standardized Payment Amount |
230408.55 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
281 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
327 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
554 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
562 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0878 |