National Provider Identifier [NPI]: |
1356470017 |
Last Name Of The Provider |
TSAI |
First Name Of The Provider |
ERIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
2391 |
Number Of Medicare Beneficiaries |
1459 |
Total Submitted Charge Amount |
447234 |
Total Medicare Allowed Amount |
56525.3 |
Total Medicare Payment Amount |
47069.33 |
Total Medicare Standardized Payment Amount |
48055.78 |
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 |
99 |
Number Of Medical Services |
2391 |
Number Of Medicare Beneficiaries With Medical Services |
1459 |
Total Medical Submitted Charge Amount |
447234 |
Total Medical Medicare Allowed Amount |
56525.3 |
Total Medical Medicare Payment Amount |
47069.33 |
Total Medical Medicare Standardized Payment Amount |
48055.78 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
714 |
Number Of Beneficiaries Age 75 to 84 |
386 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
1127 |
Number Of Male Beneficiaries |
332 |
Number Of Non Hispanic White Beneficiaries |
1401 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
1172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1365 |