National Provider Identifier [NPI]: |
1679515613 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
MELANIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4628 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWBURY |
Zip Code Of The Provider |
050514628 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
775 |
Number Of Medicare Beneficiaries |
62 |
Total Submitted Charge Amount |
115302.98 |
Total Medicare Allowed Amount |
45971.56 |
Total Medicare Payment Amount |
31246.7 |
Total Medicare Standardized Payment Amount |
35754.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1550 |
Total Drug Medicare AllowedAmount |
342.17 |
Total Drug Medicare PaymentAmount |
320.49 |
Total Drug Medicare Standardized Payment Amount |
320.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
737 |
Number Of Medicare Beneficiaries With Medical Services |
62 |
Total Medical Submitted Charge Amount |
113752.98 |
Total Medical Medicare Allowed Amount |
45629.39 |
Total Medical Medicare Payment Amount |
30926.21 |
Total Medical Medicare Standardized Payment Amount |
35433.69 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
20 |
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 |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
31 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7908 |