National Provider Identifier [NPI]: |
1962726695 |
Last Name Of The Provider |
RYAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 BOSTON MEDICAL CTR PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021182908 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
187 |
Number Of Medicare Beneficiaries |
160 |
Total Submitted Charge Amount |
90196 |
Total Medicare Allowed Amount |
26769.43 |
Total Medicare Payment Amount |
20619.76 |
Total Medicare Standardized Payment Amount |
20501.59 |
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 |
13 |
Number Of Medical Services |
187 |
Number Of Medicare Beneficiaries With Medical Services |
160 |
Total Medical Submitted Charge Amount |
90196 |
Total Medical Medicare Allowed Amount |
26769.43 |
Total Medical Medicare Payment Amount |
20619.76 |
Total Medical Medicare Standardized Payment Amount |
20501.59 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
68 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.639 |