National Provider Identifier [NPI]: |
1164417929 |
Last Name Of The Provider |
FAUST |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3640 MAIN ST |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011071145 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
2147 |
Number Of Medicare Beneficiaries |
1006 |
Total Submitted Charge Amount |
694469.12 |
Total Medicare Allowed Amount |
287037.33 |
Total Medicare Payment Amount |
198834.29 |
Total Medicare Standardized Payment Amount |
194699.78 |
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 |
26 |
Number Of Medical Services |
2147 |
Number Of Medicare Beneficiaries With Medical Services |
1006 |
Total Medical Submitted Charge Amount |
694469.12 |
Total Medical Medicare Allowed Amount |
287037.33 |
Total Medical Medicare Payment Amount |
198834.29 |
Total Medical Medicare Standardized Payment Amount |
194699.78 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
409 |
Number Of Beneficiaries Age 75 to 84 |
357 |
Number Of Beneficiaries Age Greater 84 |
207 |
Number Of Female Beneficiaries |
588 |
Number Of Male Beneficiaries |
418 |
Number Of Non Hispanic White Beneficiaries |
924 |
Number Of Black or African American Beneficiaries |
44 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
945 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0516 |