National Provider Identifier [NPI]: |
1184624488 |
Last Name Of The Provider |
CARMODY |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 MOUNT AUBURN ST |
Street Address 2 Of The Provider |
PRIMARY CARE CENTER |
City Of The Provider |
CAMBRIDGE |
Zip Code Of The Provider |
021385502 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
2403 |
Number Of Medicare Beneficiaries |
303 |
Total Submitted Charge Amount |
265388 |
Total Medicare Allowed Amount |
146778.03 |
Total Medicare Payment Amount |
109535.9 |
Total Medicare Standardized Payment Amount |
103204.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
153 |
Number Of Medicare Beneficiaries With Drug Services |
128 |
Total Drug Submitted ChargeAmount |
5784 |
Total Drug Medicare AllowedAmount |
3565.4 |
Total Drug Medicare PaymentAmount |
3490.74 |
Total Drug Medicare Standardized Payment Amount |
3490.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
2250 |
Number Of Medicare Beneficiaries With Medical Services |
303 |
Total Medical Submitted Charge Amount |
259604 |
Total Medical Medicare Allowed Amount |
143212.63 |
Total Medical Medicare Payment Amount |
106045.16 |
Total Medical Medicare Standardized Payment Amount |
99713.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
266 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0683 |