National Provider Identifier [NPI]: |
1003891136 |
Last Name Of The Provider |
GRONDIN |
First Name Of The Provider |
LYDIA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
DEPT OF ANESTHESIA WP2 |
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 |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
194 |
Number Of Medicare Beneficiaries |
143 |
Total Submitted Charge Amount |
174056.43 |
Total Medicare Allowed Amount |
31172.89 |
Total Medicare Payment Amount |
24197.27 |
Total Medicare Standardized Payment Amount |
24968.77 |
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 |
57 |
Number Of Medical Services |
194 |
Number Of Medicare Beneficiaries With Medical Services |
143 |
Total Medical Submitted Charge Amount |
174056.43 |
Total Medical Medicare Allowed Amount |
31172.89 |
Total Medical Medicare Payment Amount |
24197.27 |
Total Medical Medicare Standardized Payment Amount |
24968.77 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3059 |