National Provider Identifier [NPI]: |
1013905108 |
Last Name Of The Provider |
BUCKLE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 ELM ST |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
DEDHAM |
Zip Code Of The Provider |
020264530 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
2066 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
227904.66 |
Total Medicare Allowed Amount |
107051.35 |
Total Medicare Payment Amount |
78464.2 |
Total Medicare Standardized Payment Amount |
78202.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
385 |
Number Of Medicare Beneficiaries With Drug Services |
174 |
Total Drug Submitted ChargeAmount |
11486.1 |
Total Drug Medicare AllowedAmount |
7883.14 |
Total Drug Medicare PaymentAmount |
7334.13 |
Total Drug Medicare Standardized Payment Amount |
7334.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1681 |
Number Of Medicare Beneficiaries With Medical Services |
284 |
Total Medical Submitted Charge Amount |
216418.56 |
Total Medical Medicare Allowed Amount |
99168.21 |
Total Medical Medicare Payment Amount |
71130.07 |
Total Medical Medicare Standardized Payment Amount |
70868.58 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
267 |
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 |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2306 |