National Provider Identifier [NPI]: |
1164614517 |
Last Name Of The Provider |
RAY |
First Name Of The Provider |
MADHAB |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
41 MALL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
018050001 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
781 |
Number Of Medicare Beneficiaries |
450 |
Total Submitted Charge Amount |
245279 |
Total Medicare Allowed Amount |
97722.04 |
Total Medicare Payment Amount |
75694.78 |
Total Medicare Standardized Payment Amount |
73799.94 |
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 |
15 |
Number Of Medical Services |
781 |
Number Of Medicare Beneficiaries With Medical Services |
450 |
Total Medical Submitted Charge Amount |
245279 |
Total Medical Medicare Allowed Amount |
97722.04 |
Total Medical Medicare Payment Amount |
75694.78 |
Total Medical Medicare Standardized Payment Amount |
73799.94 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
159 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
421 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
332 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.2202 |