National Provider Identifier [NPI]: |
1104884600 |
Last Name Of The Provider |
GRIFFIN |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 CENTRE STREET |
Street Address 2 Of The Provider |
BROCKTON HOSPITAL |
City Of The Provider |
BROCKTON |
Zip Code Of The Provider |
02302 |
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 |
25 |
Number Of Services |
647 |
Number Of Medicare Beneficiaries |
582 |
Total Submitted Charge Amount |
503982.61 |
Total Medicare Allowed Amount |
86217.79 |
Total Medicare Payment Amount |
64809.29 |
Total Medicare Standardized Payment Amount |
64483.15 |
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 |
25 |
Number Of Medical Services |
647 |
Number Of Medicare Beneficiaries With Medical Services |
582 |
Total Medical Submitted Charge Amount |
503982.61 |
Total Medical Medicare Allowed Amount |
86217.79 |
Total Medical Medicare Payment Amount |
64809.29 |
Total Medical Medicare Standardized Payment Amount |
64483.15 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
262 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
295 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
454 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
338 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0004 |