National Provider Identifier [NPI]: |
1215910716 |
Last Name Of The Provider |
LARAIA |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22 MILL ST |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
024764784 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1483 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
218844 |
Total Medicare Allowed Amount |
76923.6 |
Total Medicare Payment Amount |
55275.91 |
Total Medicare Standardized Payment Amount |
50425.88 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
267 |
Number Of Black or African American Beneficiaries |
|
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 |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9947 |