National Provider Identifier [NPI]: |
1336212281 |
Last Name Of The Provider |
BRENT |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D., M.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 BROOKLINE AVENUE |
Street Address 2 Of The Provider |
DEPARTMENT OF PSYCHIATRY--RABB 2 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
02215 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
73 |
Total Submitted Charge Amount |
44499 |
Total Medicare Allowed Amount |
13326.77 |
Total Medicare Payment Amount |
10075.61 |
Total Medicare Standardized Payment Amount |
9672.46 |
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 |
2 |
Number Of Medical Services |
165 |
Number Of Medicare Beneficiaries With Medical Services |
73 |
Total Medical Submitted Charge Amount |
44499 |
Total Medical Medicare Allowed Amount |
13326.77 |
Total Medical Medicare Payment Amount |
10075.61 |
Total Medical Medicare Standardized Payment Amount |
9672.46 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
44 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
62 |
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 |
21 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
71 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.1588 |