National Provider Identifier [NPI]: |
1730126624 |
Last Name Of The Provider |
BECKWITH |
First Name Of The Provider |
CURT |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1125 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029045739 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
281 |
Number Of Medicare Beneficiaries |
117 |
Total Submitted Charge Amount |
35392.51 |
Total Medicare Allowed Amount |
23180.65 |
Total Medicare Payment Amount |
17042.76 |
Total Medicare Standardized Payment Amount |
16604.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
14 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
260.52 |
Total Drug Medicare AllowedAmount |
64.06 |
Total Drug Medicare PaymentAmount |
61.78 |
Total Drug Medicare Standardized Payment Amount |
61.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
267 |
Number Of Medicare Beneficiaries With Medical Services |
117 |
Total Medical Submitted Charge Amount |
35131.99 |
Total Medical Medicare Allowed Amount |
23116.59 |
Total Medical Medicare Payment Amount |
16980.98 |
Total Medical Medicare Standardized Payment Amount |
16543.12 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
78 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2674 |