National Provider Identifier [NPI]: |
1417970559 |
Last Name Of The Provider |
NAGLE |
First Name Of The Provider |
KEITH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
PATRICK 5 |
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
717 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
383447 |
Total Medicare Allowed Amount |
81998.01 |
Total Medicare Payment Amount |
60433.21 |
Total Medicare Standardized Payment Amount |
61688.18 |
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 |
31 |
Number Of Medical Services |
717 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
383447 |
Total Medical Medicare Allowed Amount |
81998.01 |
Total Medical Medicare Payment Amount |
60433.21 |
Total Medical Medicare Standardized Payment Amount |
61688.18 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
361 |
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 |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.5184 |