National Provider Identifier [NPI]: |
1699756916 |
Last Name Of The Provider |
BUTLER |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
170 GOVERNORS AVE |
Street Address 2 Of The Provider |
LAWRENCE MEMORIAL HOSPITAL |
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
021551643 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
708 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
186170 |
Total Medicare Allowed Amount |
52732.22 |
Total Medicare Payment Amount |
38731.4 |
Total Medicare Standardized Payment Amount |
36976.73 |
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 |
29 |
Number Of Medical Services |
708 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
186170 |
Total Medical Medicare Allowed Amount |
52732.22 |
Total Medical Medicare Payment Amount |
38731.4 |
Total Medical Medicare Standardized Payment Amount |
36976.73 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6452 |