National Provider Identifier [NPI]: |
1659376184 |
Last Name Of The Provider |
DIFRESCO |
First Name Of The Provider |
VERONICA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1201 SEVEN LOCKS RD |
Street Address 2 Of The Provider |
STE 111 |
City Of The Provider |
ROCKVILLE |
Zip Code Of The Provider |
208542957 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
486 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
40522.35 |
Total Medicare Allowed Amount |
25049.21 |
Total Medicare Payment Amount |
17235.19 |
Total Medicare Standardized Payment Amount |
16171.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
898.06 |
Total Drug Medicare AllowedAmount |
898.06 |
Total Drug Medicare PaymentAmount |
880.04 |
Total Drug Medicare Standardized Payment Amount |
880.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
467 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
39624.29 |
Total Medical Medicare Allowed Amount |
24151.15 |
Total Medical Medicare Payment Amount |
16355.15 |
Total Medical Medicare Standardized Payment Amount |
15291.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
18 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
10 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8807 |