National Provider Identifier [NPI]: |
1306930581 |
Last Name Of The Provider |
TANZER |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29 NORTHWEST BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHUA |
Zip Code Of The Provider |
030634068 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
832 |
Number Of Medicare Beneficiaries |
411 |
Total Submitted Charge Amount |
118117 |
Total Medicare Allowed Amount |
57532.46 |
Total Medicare Payment Amount |
36775.94 |
Total Medicare Standardized Payment Amount |
36658.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1984 |
Total Drug Medicare AllowedAmount |
1203.6 |
Total Drug Medicare PaymentAmount |
1153.32 |
Total Drug Medicare Standardized Payment Amount |
1153.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
784 |
Number Of Medicare Beneficiaries With Medical Services |
411 |
Total Medical Submitted Charge Amount |
116133 |
Total Medical Medicare Allowed Amount |
56328.86 |
Total Medical Medicare Payment Amount |
35622.62 |
Total Medical Medicare Standardized Payment Amount |
35505.1 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
385 |
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 |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0096 |