National Provider Identifier [NPI]: |
1811956329 |
Last Name Of The Provider |
BENDETSON |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1180 BEACON STREET, SUITE 3A |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKLINE |
Zip Code Of The Provider |
024463806 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1526 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
267979 |
Total Medicare Allowed Amount |
142060.51 |
Total Medicare Payment Amount |
108887.15 |
Total Medicare Standardized Payment Amount |
99961.1 |
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 |
48 |
Number Of Medical Services |
1526 |
Number Of Medicare Beneficiaries With Medical Services |
284 |
Total Medical Submitted Charge Amount |
267979 |
Total Medical Medicare Allowed Amount |
142060.51 |
Total Medical Medicare Payment Amount |
108887.15 |
Total Medical Medicare Standardized Payment Amount |
99961.1 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
233 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0959 |