National Provider Identifier [NPI]: |
1801050190 |
Last Name Of The Provider |
HEBERT |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
275 SANDWICH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLYMOUTH |
Zip Code Of The Provider |
023602183 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
919 |
Number Of Medicare Beneficiaries |
649 |
Total Submitted Charge Amount |
248191 |
Total Medicare Allowed Amount |
92184.17 |
Total Medicare Payment Amount |
68687.34 |
Total Medicare Standardized Payment Amount |
80473.9 |
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 |
22 |
Number Of Medical Services |
919 |
Number Of Medicare Beneficiaries With Medical Services |
649 |
Total Medical Submitted Charge Amount |
248191 |
Total Medical Medicare Allowed Amount |
92184.17 |
Total Medical Medicare Payment Amount |
68687.34 |
Total Medical Medicare Standardized Payment Amount |
80473.9 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
412 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
630 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
488 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.7646 |