National Provider Identifier [NPI]: |
1386663094 |
Last Name Of The Provider |
MACDONALD |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 FISHER RD |
Street Address 2 Of The Provider |
MOB- A SUITE 2-1 |
City Of The Provider |
BERLIN |
Zip Code Of The Provider |
056029516 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
2230 |
Number Of Medicare Beneficiaries |
1216 |
Total Submitted Charge Amount |
217998 |
Total Medicare Allowed Amount |
111836.51 |
Total Medicare Payment Amount |
82787.73 |
Total Medicare Standardized Payment Amount |
84362 |
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 |
32 |
Number Of Medical Services |
2230 |
Number Of Medicare Beneficiaries With Medical Services |
1216 |
Total Medical Submitted Charge Amount |
217998 |
Total Medical Medicare Allowed Amount |
111836.51 |
Total Medical Medicare Payment Amount |
82787.73 |
Total Medical Medicare Standardized Payment Amount |
84362 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
355 |
Number Of Beneficiaries Age 75 to 84 |
435 |
Number Of Beneficiaries Age Greater 84 |
261 |
Number Of Female Beneficiaries |
609 |
Number Of Male Beneficiaries |
607 |
Number Of Non Hispanic White Beneficiaries |
1180 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
876 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
340 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3352 |