National Provider Identifier [NPI]: |
1689641870 |
Last Name Of The Provider |
CHARNIN |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
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 |
GRJ 402 |
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 |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
485 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
410768 |
Total Medicare Allowed Amount |
86960.25 |
Total Medicare Payment Amount |
67997.04 |
Total Medicare Standardized Payment Amount |
66408.35 |
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 |
55 |
Number Of Medical Services |
485 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
410768 |
Total Medical Medicare Allowed Amount |
86960.25 |
Total Medical Medicare Payment Amount |
67997.04 |
Total Medical Medicare Standardized Payment Amount |
66408.35 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2602 |