National Provider Identifier [NPI]: |
1639169261 |
Last Name Of The Provider |
LYN |
First Name Of The Provider |
EVERETT |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
45 FRANCIS ST |
Street Address 2 Of The Provider |
BRIGHAM AND WOMEN'S HOSPITAL DEPT OF EMERGENCY MEDICINE |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021156105 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
185 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
81696 |
Total Medicare Allowed Amount |
23429.97 |
Total Medicare Payment Amount |
17830.93 |
Total Medicare Standardized Payment Amount |
17860.13 |
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 |
9 |
Number Of Medical Services |
185 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
81696 |
Total Medical Medicare Allowed Amount |
23429.97 |
Total Medical Medicare Payment Amount |
17830.93 |
Total Medical Medicare Standardized Payment Amount |
17860.13 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
147 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
101 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.684 |