National Provider Identifier [NPI]: |
1366476889 |
Last Name Of The Provider |
GRAU |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5200 CENTRE AVE |
Street Address 2 Of The Provider |
SHEA MEDICAL CENTER, SUITE 509 |
City Of The Provider |
PITTSBURGH |
Zip Code Of The Provider |
152321300 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
266 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
54566 |
Total Medicare Allowed Amount |
22121.42 |
Total Medicare Payment Amount |
16677.34 |
Total Medicare Standardized Payment Amount |
17046.02 |
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 |
17 |
Number Of Medical Services |
266 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
54566 |
Total Medical Medicare Allowed Amount |
22121.42 |
Total Medical Medicare Payment Amount |
16677.34 |
Total Medical Medicare Standardized Payment Amount |
17046.02 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
54 |
Number Of Black or African American Beneficiaries |
|
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 |
55 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.6153 |