National Provider Identifier [NPI]: |
1598726622 |
Last Name Of The Provider |
HABERSHAW |
First Name Of The Provider |
GEOFFREY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
732 HARRISON AVE |
Street Address 2 Of The Provider |
PRESTON 5TH FLOOR |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021182656 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1482 |
Number Of Medicare Beneficiaries |
632 |
Total Submitted Charge Amount |
271670.84 |
Total Medicare Allowed Amount |
103603.93 |
Total Medicare Payment Amount |
75548.69 |
Total Medicare Standardized Payment Amount |
73293.99 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
1482 |
Number Of Medicare Beneficiaries With Medical Services |
632 |
Total Medical Submitted Charge Amount |
271670.84 |
Total Medical Medicare Allowed Amount |
103603.93 |
Total Medical Medicare Payment Amount |
75548.69 |
Total Medical Medicare Standardized Payment Amount |
73293.99 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
312 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
391 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.9443 |