National Provider Identifier [NPI]: |
1689985012 |
Last Name Of The Provider |
BUCCI |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
615 S BALLAS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631225314 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
985 |
Number Of Medicare Beneficiaries |
429 |
Total Submitted Charge Amount |
168781 |
Total Medicare Allowed Amount |
102448.14 |
Total Medicare Payment Amount |
79924.51 |
Total Medicare Standardized Payment Amount |
81001.28 |
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 |
18 |
Number Of Medical Services |
985 |
Number Of Medicare Beneficiaries With Medical Services |
429 |
Total Medical Submitted Charge Amount |
168781 |
Total Medical Medicare Allowed Amount |
102448.14 |
Total Medical Medicare Payment Amount |
79924.51 |
Total Medical Medicare Standardized Payment Amount |
81001.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
251 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
366 |
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 |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4561 |