National Provider Identifier [NPI]: |
1316930142 |
Last Name Of The Provider |
ESTES |
First Name Of The Provider |
SHEREE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PSY D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
189 MAY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
016024339 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
200 |
Number Of Medicare Beneficiaries |
154 |
Total Submitted Charge Amount |
35340 |
Total Medicare Allowed Amount |
24628.14 |
Total Medicare Payment Amount |
19087.63 |
Total Medicare Standardized Payment Amount |
18646.32 |
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 |
3 |
Number Of Medical Services |
200 |
Number Of Medicare Beneficiaries With Medical Services |
154 |
Total Medical Submitted Charge Amount |
35340 |
Total Medical Medicare Allowed Amount |
24628.14 |
Total Medical Medicare Payment Amount |
19087.63 |
Total Medical Medicare Standardized Payment Amount |
18646.32 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
73 |
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 |
105 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
42 |
Average HCC Risk Score Of Beneficiaries |
1.701 |