National Provider Identifier [NPI]: |
1164446407 |
Last Name Of The Provider |
SWANN |
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 |
100 HOSPITAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BENNINGTON |
Zip Code Of The Provider |
052015004 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1421 |
Number Of Medicare Beneficiaries |
617 |
Total Submitted Charge Amount |
342957.75 |
Total Medicare Allowed Amount |
130505.8 |
Total Medicare Payment Amount |
101773.01 |
Total Medicare Standardized Payment Amount |
103085.41 |
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 |
20 |
Number Of Medical Services |
1421 |
Number Of Medicare Beneficiaries With Medical Services |
617 |
Total Medical Submitted Charge Amount |
342957.75 |
Total Medical Medicare Allowed Amount |
130505.8 |
Total Medical Medicare Payment Amount |
101773.01 |
Total Medical Medicare Standardized Payment Amount |
103085.41 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
212 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
605 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
233 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8288 |