National Provider Identifier [NPI]: |
1780645598 |
Last Name Of The Provider |
KOLBJORNSEN |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 LOCUST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTHAMPTON |
Zip Code Of The Provider |
010602052 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
155 |
Number Of Services |
3615 |
Number Of Medicare Beneficiaries |
2164 |
Total Submitted Charge Amount |
391810 |
Total Medicare Allowed Amount |
114871.9 |
Total Medicare Payment Amount |
90555.51 |
Total Medicare Standardized Payment Amount |
90205 |
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 |
155 |
Number Of Medical Services |
3615 |
Number Of Medicare Beneficiaries With Medical Services |
2164 |
Total Medical Submitted Charge Amount |
391810 |
Total Medical Medicare Allowed Amount |
114871.9 |
Total Medical Medicare Payment Amount |
90555.51 |
Total Medical Medicare Standardized Payment Amount |
90205 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
347 |
Number Of Beneficiaries Age 65 to 74 |
842 |
Number Of Beneficiaries Age 75 to 84 |
578 |
Number Of Beneficiaries Age Greater 84 |
397 |
Number Of Female Beneficiaries |
1391 |
Number Of Male Beneficiaries |
773 |
Number Of Non Hispanic White Beneficiaries |
1994 |
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
73 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
1599 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
565 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3132 |