National Provider Identifier [NPI]: |
1306867973 |
Last Name Of The Provider |
BIRENBAUM |
First Name Of The Provider |
DEBRA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 MEDICAL CENTER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEBANON |
Zip Code Of The Provider |
037561000 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
567 |
Number Of Medicare Beneficiaries |
352 |
Total Submitted Charge Amount |
41630.81 |
Total Medicare Allowed Amount |
25087.86 |
Total Medicare Payment Amount |
17991.28 |
Total Medicare Standardized Payment Amount |
17913.59 |
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 |
24 |
Number Of Medical Services |
567 |
Number Of Medicare Beneficiaries With Medical Services |
352 |
Total Medical Submitted Charge Amount |
41630.81 |
Total Medical Medicare Allowed Amount |
25087.86 |
Total Medical Medicare Payment Amount |
17991.28 |
Total Medical Medicare Standardized Payment Amount |
17913.59 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
352 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
337 |
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 |
324 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
5 |
Percent Of With Chronic Kidney Disease |
4 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
35 |
Percent Of With Ischemic Heart Disease |
9 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7823 |