National Provider Identifier [NPI]: |
1245323112 |
Last Name Of The Provider |
GOLDBERG |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
LAHEY CLINIC |
Street Address 2 Of The Provider |
41 MALL ROAD |
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
018050001 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
416 |
Total Submitted Charge Amount |
324677 |
Total Medicare Allowed Amount |
92692.77 |
Total Medicare Payment Amount |
72490.22 |
Total Medicare Standardized Payment Amount |
70339.74 |
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 |
39 |
Number Of Medical Services |
589 |
Number Of Medicare Beneficiaries With Medical Services |
416 |
Total Medical Submitted Charge Amount |
324677 |
Total Medical Medicare Allowed Amount |
92692.77 |
Total Medical Medicare Payment Amount |
72490.22 |
Total Medical Medicare Standardized Payment Amount |
70339.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
328 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3378 |