| National Provider Identifier [NPI]: | 1396733671 |
| Last Name Of The Provider | KRUPA |
| First Name Of The Provider | MELANIE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1233 MAIN ST |
| Street Address 2 Of The Provider | PROVIDENCE BEHAVIORAL HEALTH HOSPITAL |
| City Of The Provider | HOLYOKE |
| Zip Code Of The Provider | 010405381 |
| 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 | 6 |
| Number Of Services | 353 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 63749 |
| Total Medicare Allowed Amount | 29609.13 |
| Total Medicare Payment Amount | 20352.79 |
| Total Medicare Standardized Payment Amount | 23930.68 |
| 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 | 6 |
| Number Of Medical Services | 353 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 63749 |
| Total Medical Medicare Allowed Amount | 29609.13 |
| Total Medical Medicare Payment Amount | 20352.79 |
| Total Medical Medicare Standardized Payment Amount | 23930.68 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 147 |
| Number Of Black or African American Beneficiaries | 19 |
| 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 | 41 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.4273 |