National Provider Identifier [NPI]: |
1356441638 |
Last Name Of The Provider |
RAHN |
First Name Of The Provider |
SHELLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
444 MONTGOMERY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICOPEE |
Zip Code Of The Provider |
010201969 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
166 |
Number Of Medicare Beneficiaries |
75 |
Total Submitted Charge Amount |
38457 |
Total Medicare Allowed Amount |
16643.01 |
Total Medicare Payment Amount |
12724.43 |
Total Medicare Standardized Payment Amount |
12486.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
226 |
Total Drug Medicare AllowedAmount |
149.23 |
Total Drug Medicare PaymentAmount |
125.52 |
Total Drug Medicare Standardized Payment Amount |
125.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
144 |
Number Of Medicare Beneficiaries With Medical Services |
75 |
Total Medical Submitted Charge Amount |
38231 |
Total Medical Medicare Allowed Amount |
16493.78 |
Total Medical Medicare Payment Amount |
12598.91 |
Total Medical Medicare Standardized Payment Amount |
12361.16 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
40 |
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 |
29 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
17 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
35 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2389 |