National Provider Identifier [NPI]: |
1659682961 |
Last Name Of The Provider |
JANKOWSKA |
First Name Of The Provider |
EWA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
294 DW HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERRIMACK |
Zip Code Of The Provider |
030544474 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
95607.66 |
Total Medicare Allowed Amount |
36644.11 |
Total Medicare Payment Amount |
25142.66 |
Total Medicare Standardized Payment Amount |
25304.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
78 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
5090.66 |
Total Drug Medicare AllowedAmount |
1668.12 |
Total Drug Medicare PaymentAmount |
1520.7 |
Total Drug Medicare Standardized Payment Amount |
1520.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
511 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
90517 |
Total Medical Medicare Allowed Amount |
34975.99 |
Total Medical Medicare Payment Amount |
23621.96 |
Total Medical Medicare Standardized Payment Amount |
23783.41 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
77 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.8779 |