National Provider Identifier [NPI]: |
1619975489 |
Last Name Of The Provider |
STEBBINS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
41 GOVERNORS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
PRINCETON |
Zip Code Of The Provider |
085403670 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
3220 |
Number Of Medicare Beneficiaries |
627 |
Total Submitted Charge Amount |
369016.7 |
Total Medicare Allowed Amount |
119337.24 |
Total Medicare Payment Amount |
93945.05 |
Total Medicare Standardized Payment Amount |
85712.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
2032 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
820.7 |
Total Drug Medicare AllowedAmount |
429.1 |
Total Drug Medicare PaymentAmount |
336.4 |
Total Drug Medicare Standardized Payment Amount |
336.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
91 |
Number Of Medical Services |
1188 |
Number Of Medicare Beneficiaries With Medical Services |
627 |
Total Medical Submitted Charge Amount |
368196 |
Total Medical Medicare Allowed Amount |
118908.14 |
Total Medical Medicare Payment Amount |
93608.65 |
Total Medical Medicare Standardized Payment Amount |
85376.15 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
228 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
408 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
170 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
131 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
286 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2739 |