National Provider Identifier [NPI]: |
1730109026 |
Last Name Of The Provider |
LIPTZIN |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
759 CHESTNUT ST |
Street Address 2 Of The Provider |
S5632 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011991619 |
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 |
22 |
Number Of Services |
739 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
123024 |
Total Medicare Allowed Amount |
63841.51 |
Total Medicare Payment Amount |
48921.1 |
Total Medicare Standardized Payment Amount |
48146.57 |
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 |
739 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
123024 |
Total Medical Medicare Allowed Amount |
63841.51 |
Total Medical Medicare Payment Amount |
48921.1 |
Total Medical Medicare Standardized Payment Amount |
48146.57 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
146 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
43 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5727 |