National Provider Identifier [NPI]: |
1174705636 |
Last Name Of The Provider |
YEBOAH |
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 |
20 YORK STREET, CB-2041 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
06510 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1204 |
Number Of Medicare Beneficiaries |
535 |
Total Submitted Charge Amount |
289223 |
Total Medicare Allowed Amount |
151470.87 |
Total Medicare Payment Amount |
112411.98 |
Total Medicare Standardized Payment Amount |
105576.12 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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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 |
75 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
412 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
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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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
294 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3164 |