National Provider Identifier [NPI]: |
1386694453 |
Last Name Of The Provider |
SANDIN |
First Name Of The Provider |
ANN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 CONCORD AVE |
Street Address 2 Of The Provider |
SUITE 2000 |
City Of The Provider |
CAMBRIDGE |
Zip Code Of The Provider |
021381040 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1524 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
149956 |
Total Medicare Allowed Amount |
83490.45 |
Total Medicare Payment Amount |
63277.83 |
Total Medicare Standardized Payment Amount |
59712.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
141 |
Number Of Medicare Beneficiaries With Drug Services |
120 |
Total Drug Submitted ChargeAmount |
5565 |
Total Drug Medicare AllowedAmount |
3761.79 |
Total Drug Medicare PaymentAmount |
3680.95 |
Total Drug Medicare Standardized Payment Amount |
3680.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1383 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
144391 |
Total Medical Medicare Allowed Amount |
79728.66 |
Total Medical Medicare Payment Amount |
59596.88 |
Total Medical Medicare Standardized Payment Amount |
56031.46 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9916 |