National Provider Identifier [NPI]: |
1093855298 |
Last Name Of The Provider |
FORAN |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
150 YORK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
STOUGHTON |
Zip Code Of The Provider |
020721829 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
381 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
70308 |
Total Medicare Allowed Amount |
31890.62 |
Total Medicare Payment Amount |
25001.13 |
Total Medicare Standardized Payment Amount |
28013.23 |
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 |
7 |
Number Of Medical Services |
381 |
Number Of Medicare Beneficiaries With Medical Services |
68 |
Total Medical Submitted Charge Amount |
70308 |
Total Medical Medicare Allowed Amount |
31890.62 |
Total Medical Medicare Payment Amount |
25001.13 |
Total Medical Medicare Standardized Payment Amount |
28013.23 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
30 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
42 |
Number Of Black or African American Beneficiaries |
12 |
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 |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
69 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
62 |
Percent Of With Depression |
65 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
4.1081 |