National Provider Identifier [NPI]: |
1780627018 |
Last Name Of The Provider |
GIANCARLO |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
34025 HARPER |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLINTON TOWNSHIP |
Zip Code Of The Provider |
48043 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
128 |
Number Of Services |
23304 |
Number Of Medicare Beneficiaries |
2154 |
Total Submitted Charge Amount |
1304247.5 |
Total Medicare Allowed Amount |
886161.87 |
Total Medicare Payment Amount |
666133.08 |
Total Medicare Standardized Payment Amount |
665817.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
19 |
Number Of Drug Services |
16420 |
Number Of Medicare Beneficiaries With Drug Services |
182 |
Total Drug Submitted ChargeAmount |
198827 |
Total Drug Medicare AllowedAmount |
168624.71 |
Total Drug Medicare PaymentAmount |
131151.11 |
Total Drug Medicare Standardized Payment Amount |
131151.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
109 |
Number Of Medical Services |
6884 |
Number Of Medicare Beneficiaries With Medical Services |
2154 |
Total Medical Submitted Charge Amount |
1105420.5 |
Total Medical Medicare Allowed Amount |
717537.16 |
Total Medical Medicare Payment Amount |
534981.97 |
Total Medical Medicare Standardized Payment Amount |
534666.84 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
1028 |
Number Of Beneficiaries Age 65 to 74 |
519 |
Number Of Beneficiaries Age 75 to 84 |
365 |
Number Of Beneficiaries Age Greater 84 |
242 |
Number Of Female Beneficiaries |
1298 |
Number Of Male Beneficiaries |
856 |
Number Of Non Hispanic White Beneficiaries |
1539 |
Number Of Black or African American Beneficiaries |
559 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
940 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
1.9365 |