National Provider Identifier [NPI]: |
1558377739 |
Last Name Of The Provider |
PAULIN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1423 CHAPEL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
06511 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
380749.61 |
Total Medicare Allowed Amount |
44723.02 |
Total Medicare Payment Amount |
34941.23 |
Total Medicare Standardized Payment Amount |
33108.16 |
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 |
63 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
380749.61 |
Total Medical Medicare Allowed Amount |
44723.02 |
Total Medical Medicare Payment Amount |
34941.23 |
Total Medical Medicare Standardized Payment Amount |
33108.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
219 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.5496 |