National Provider Identifier [NPI]: |
1851333546 |
Last Name Of The Provider |
EBB |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 MEMORIAL DRIVE |
Street Address 2 Of The Provider |
SUITE 108 |
City Of The Provider |
LEOMINSTER |
Zip Code Of The Provider |
01453 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
2530 |
Number Of Medicare Beneficiaries |
751 |
Total Submitted Charge Amount |
623715 |
Total Medicare Allowed Amount |
254495.33 |
Total Medicare Payment Amount |
185862.69 |
Total Medicare Standardized Payment Amount |
181624.77 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
302 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
578 |
Number Of Non Hispanic White Beneficiaries |
676 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
567 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2845 |