National Provider Identifier [NPI]: |
1093888919 |
Last Name Of The Provider |
SWEN |
First Name Of The Provider |
JEANNE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1660 BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CRANSTON |
Zip Code Of The Provider |
029052730 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
256 |
Number Of Medicare Beneficiaries |
53 |
Total Submitted Charge Amount |
20162.59 |
Total Medicare Allowed Amount |
18393.01 |
Total Medicare Payment Amount |
13676.2 |
Total Medicare Standardized Payment Amount |
13408.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
470.5 |
Total Drug Medicare AllowedAmount |
427.06 |
Total Drug Medicare PaymentAmount |
418.4 |
Total Drug Medicare Standardized Payment Amount |
418.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
225 |
Number Of Medicare Beneficiaries With Medical Services |
53 |
Total Medical Submitted Charge Amount |
19692.09 |
Total Medical Medicare Allowed Amount |
17965.95 |
Total Medical Medicare Payment Amount |
13257.8 |
Total Medical Medicare Standardized Payment Amount |
12990.18 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
21 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
17 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
0 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
23 |
Percent Of With Hypertension |
28 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8441 |