National Provider Identifier [NPI]: |
1699738187 |
Last Name Of The Provider |
ROKHLENKO |
First Name Of The Provider |
ANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
444 MONTGOMERY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICOPEE |
Zip Code Of The Provider |
010210389 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
132 |
Number Of Services |
9170 |
Number Of Medicare Beneficiaries |
2221 |
Total Submitted Charge Amount |
1047187 |
Total Medicare Allowed Amount |
339250.25 |
Total Medicare Payment Amount |
272446.9 |
Total Medicare Standardized Payment Amount |
261391.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
5560 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
9780 |
Total Drug Medicare AllowedAmount |
3145.84 |
Total Drug Medicare PaymentAmount |
2466.36 |
Total Drug Medicare Standardized Payment Amount |
2466.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
129 |
Number Of Medical Services |
3610 |
Number Of Medicare Beneficiaries With Medical Services |
2221 |
Total Medical Submitted Charge Amount |
1037407 |
Total Medical Medicare Allowed Amount |
336104.41 |
Total Medical Medicare Payment Amount |
269980.54 |
Total Medical Medicare Standardized Payment Amount |
258925.35 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
660 |
Number Of Beneficiaries Age 65 to 74 |
906 |
Number Of Beneficiaries Age 75 to 84 |
482 |
Number Of Beneficiaries Age Greater 84 |
173 |
Number Of Female Beneficiaries |
1646 |
Number Of Male Beneficiaries |
575 |
Number Of Non Hispanic White Beneficiaries |
1694 |
Number Of Black or African American Beneficiaries |
157 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
317 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
1304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
917 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1364 |