National Provider Identifier [NPI]: |
1831134485 |
Last Name Of The Provider |
HELSTROM |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT ST |
Street Address 2 Of The Provider |
CLN 309 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142621 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
155 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
116764.19 |
Total Medicare Allowed Amount |
19621.61 |
Total Medicare Payment Amount |
15353.57 |
Total Medicare Standardized Payment Amount |
14507.92 |
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 |
27 |
Number Of Medical Services |
155 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
116764.19 |
Total Medical Medicare Allowed Amount |
19621.61 |
Total Medical Medicare Payment Amount |
15353.57 |
Total Medical Medicare Standardized Payment Amount |
14507.92 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
125 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
36 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4631 |