National Provider Identifier [NPI]: |
1396739231 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
LUZ |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
299 CAREW ST |
Street Address 2 Of The Provider |
SUITE NUMBER 300 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011042301 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
670 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
80150 |
Total Medicare Allowed Amount |
69425.68 |
Total Medicare Payment Amount |
47697.43 |
Total Medicare Standardized Payment Amount |
50265.81 |
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 |
4 |
Number Of Medical Services |
670 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
80150 |
Total Medical Medicare Allowed Amount |
69425.68 |
Total Medical Medicare Payment Amount |
47697.43 |
Total Medical Medicare Standardized Payment Amount |
50265.81 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
213 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
181 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
37 |
Percent Of With Ischemic Heart Disease |
11 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1384 |