National Provider Identifier [NPI]: |
1548365554 |
Last Name Of The Provider |
DESILLIER |
First Name Of The Provider |
ELENA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
736 CAMBRIDGE ST |
Street Address 2 Of The Provider |
DEPT. ANESTHESIOLOGY & PAIN MEDICINE |
City Of The Provider |
BRIGHTON |
Zip Code Of The Provider |
021352907 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
614 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
232866 |
Total Medicare Allowed Amount |
63297.68 |
Total Medicare Payment Amount |
48197.98 |
Total Medicare Standardized Payment Amount |
45551.61 |
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 |
75 |
Number Of Medical Services |
614 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
232866 |
Total Medical Medicare Allowed Amount |
63297.68 |
Total Medical Medicare Payment Amount |
48197.98 |
Total Medical Medicare Standardized Payment Amount |
45551.61 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
190 |
Number Of Black or African American Beneficiaries |
26 |
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 |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8133 |