National Provider Identifier [NPI]: |
1063413631 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
DONALD |
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 |
100 TER HEUN DRIVE |
Street Address 2 Of The Provider |
FALMOUTH HOSPITAL |
City Of The Provider |
FALMOUTH |
Zip Code Of The Provider |
02540 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1362 |
Number Of Medicare Beneficiaries |
669 |
Total Submitted Charge Amount |
231674.38 |
Total Medicare Allowed Amount |
120617.75 |
Total Medicare Payment Amount |
92923.07 |
Total Medicare Standardized Payment Amount |
92781.52 |
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 |
22 |
Number Of Medical Services |
1362 |
Number Of Medicare Beneficiaries With Medical Services |
669 |
Total Medical Submitted Charge Amount |
231674.38 |
Total Medical Medicare Allowed Amount |
120617.75 |
Total Medical Medicare Payment Amount |
92923.07 |
Total Medical Medicare Standardized Payment Amount |
92781.52 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
237 |
Number Of Female Beneficiaries |
364 |
Number Of Male Beneficiaries |
305 |
Number Of Non Hispanic White Beneficiaries |
638 |
Number Of Black or African American Beneficiaries |
13 |
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 |
525 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0799 |