National Provider Identifier [NPI]: |
1821071861 |
Last Name Of The Provider |
BLANCHETTE |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
312 BEDFORD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHITMAN |
Zip Code Of The Provider |
023821859 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
2966 |
Number Of Medicare Beneficiaries |
519 |
Total Submitted Charge Amount |
728313 |
Total Medicare Allowed Amount |
241517.7 |
Total Medicare Payment Amount |
170876.66 |
Total Medicare Standardized Payment Amount |
167931.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
220 |
Number Of Medicare Beneficiaries With Drug Services |
189 |
Total Drug Submitted ChargeAmount |
14071 |
Total Drug Medicare AllowedAmount |
5505.56 |
Total Drug Medicare PaymentAmount |
5386.21 |
Total Drug Medicare Standardized Payment Amount |
5386.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
2746 |
Number Of Medicare Beneficiaries With Medical Services |
519 |
Total Medical Submitted Charge Amount |
714242 |
Total Medical Medicare Allowed Amount |
236012.14 |
Total Medical Medicare Payment Amount |
165490.45 |
Total Medical Medicare Standardized Payment Amount |
162545.65 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
274 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
261 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
493 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
435 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.058 |