National Provider Identifier [NPI]: |
1962654814 |
Last Name Of The Provider |
DOUCET |
First Name Of The Provider |
DANIELLE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 LAKE AVE N |
Street Address 2 Of The Provider |
DEPARTMENT OF VASCULAR SURGERY |
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
016550002 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
965 |
Number Of Medicare Beneficiaries |
403 |
Total Submitted Charge Amount |
1620997 |
Total Medicare Allowed Amount |
197755.95 |
Total Medicare Payment Amount |
152925.23 |
Total Medicare Standardized Payment Amount |
153065.18 |
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 |
125 |
Number Of Medical Services |
965 |
Number Of Medicare Beneficiaries With Medical Services |
403 |
Total Medical Submitted Charge Amount |
1620997 |
Total Medical Medicare Allowed Amount |
197755.95 |
Total Medical Medicare Payment Amount |
152925.23 |
Total Medical Medicare Standardized Payment Amount |
153065.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
363 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.9769 |