National Provider Identifier [NPI]: |
1164406930 |
Last Name Of The Provider |
NEILL |
First Name Of The Provider |
MARGUERITE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 BREWSTER ST |
Street Address 2 Of The Provider |
DEPARTMENT OF INFECTIOUS DISEASE |
City Of The Provider |
PAWTUCKET |
Zip Code Of The Provider |
028604400 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
313 |
Number Of Medicare Beneficiaries |
106 |
Total Submitted Charge Amount |
76695 |
Total Medicare Allowed Amount |
34890.05 |
Total Medicare Payment Amount |
27217.67 |
Total Medicare Standardized Payment Amount |
26574.71 |
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 |
17 |
Number Of Medical Services |
313 |
Number Of Medicare Beneficiaries With Medical Services |
106 |
Total Medical Submitted Charge Amount |
76695 |
Total Medical Medicare Allowed Amount |
34890.05 |
Total Medical Medicare Payment Amount |
27217.67 |
Total Medical Medicare Standardized Payment Amount |
26574.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
89 |
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 |
47 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
28 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
3.1428 |