National Provider Identifier [NPI]: |
1023025418 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
JAMES |
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 |
160 ALLEN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RUTLAND |
Zip Code Of The Provider |
057014560 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
954 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
257565 |
Total Medicare Allowed Amount |
87553 |
Total Medicare Payment Amount |
68563.55 |
Total Medicare Standardized Payment Amount |
69472.84 |
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 |
20 |
Number Of Medical Services |
954 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
257565 |
Total Medical Medicare Allowed Amount |
87553 |
Total Medical Medicare Payment Amount |
68563.55 |
Total Medical Medicare Standardized Payment Amount |
69472.84 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
142 |
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 |
145 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9137 |