National Provider Identifier [NPI]: |
1962660308 |
Last Name Of The Provider |
FUEHRLEIN |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
950 CAMPBELL AVE |
Street Address 2 Of The Provider |
DEPARTMENT OF PSYCHIATRY |
City Of The Provider |
WEST HAVEN |
Zip Code Of The Provider |
065162770 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
270 |
Number Of Medicare Beneficiaries |
99 |
Total Submitted Charge Amount |
74123 |
Total Medicare Allowed Amount |
22689.2 |
Total Medicare Payment Amount |
17267.67 |
Total Medicare Standardized Payment Amount |
17191.01 |
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 |
8 |
Number Of Medical Services |
270 |
Number Of Medicare Beneficiaries With Medical Services |
99 |
Total Medical Submitted Charge Amount |
74123 |
Total Medical Medicare Allowed Amount |
22689.2 |
Total Medical Medicare Payment Amount |
17267.67 |
Total Medical Medicare Standardized Payment Amount |
17191.01 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
77 |
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 |
55 |
Number Of Non Hispanic White Beneficiaries |
84 |
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 |
36 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3156 |