National Provider Identifier [NPI]: |
1376526988 |
Last Name Of The Provider |
BUSS |
First Name Of The Provider |
JANE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 SILAS DEANE HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
WETHERSFIELD |
Zip Code Of The Provider |
061094229 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
597 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
86072 |
Total Medicare Allowed Amount |
45524.86 |
Total Medicare Payment Amount |
29501.06 |
Total Medicare Standardized Payment Amount |
27719.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
1287 |
Total Drug Medicare AllowedAmount |
646.58 |
Total Drug Medicare PaymentAmount |
633.64 |
Total Drug Medicare Standardized Payment Amount |
633.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
567 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
84785 |
Total Medical Medicare Allowed Amount |
44878.28 |
Total Medical Medicare Payment Amount |
28867.42 |
Total Medical Medicare Standardized Payment Amount |
27085.76 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
229 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
209 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9057 |