National Provider Identifier [NPI]: |
1770594038 |
Last Name Of The Provider |
MCCLANE |
First Name Of The Provider |
STEVEN |
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 |
70 MILL RIVER ST |
Street Address 2 Of The Provider |
SUITE LL1 |
City Of The Provider |
STAMFORD |
Zip Code Of The Provider |
06902 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Colorectal Surgery (formerly proctology) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
564 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
409643 |
Total Medicare Allowed Amount |
163401.44 |
Total Medicare Payment Amount |
127186.64 |
Total Medicare Standardized Payment Amount |
118261.3 |
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 |
69 |
Number Of Medical Services |
564 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
409643 |
Total Medical Medicare Allowed Amount |
163401.44 |
Total Medical Medicare Payment Amount |
127186.64 |
Total Medical Medicare Standardized Payment Amount |
118261.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
122 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
39 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6531 |