National Provider Identifier [NPI]: |
1972618817 |
Last Name Of The Provider |
GABRIEL |
First Name Of The Provider |
TIMOTEO |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1941 LIMESTONE RD |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
198085400 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
5952 |
Number Of Medicare Beneficiaries |
1209 |
Total Submitted Charge Amount |
516783.5 |
Total Medicare Allowed Amount |
296717.32 |
Total Medicare Payment Amount |
214403.03 |
Total Medicare Standardized Payment Amount |
212316.32 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
529 |
Number Of Beneficiaries Age 75 to 84 |
393 |
Number Of Beneficiaries Age Greater 84 |
161 |
Number Of Female Beneficiaries |
723 |
Number Of Male Beneficiaries |
486 |
Number Of Non Hispanic White Beneficiaries |
1011 |
Number Of Black or African American Beneficiaries |
123 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1062 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0506 |