National Provider Identifier [NPI]: |
1477584738 |
Last Name Of The Provider |
HEALEY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
308 BLAKELY RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
COLCHESTER |
Zip Code Of The Provider |
054463901 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
788 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
384361.5 |
Total Medicare Allowed Amount |
129472.22 |
Total Medicare Payment Amount |
99934.92 |
Total Medicare Standardized Payment Amount |
99738.49 |
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 |
86 |
Number Of Medical Services |
788 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
384361.5 |
Total Medical Medicare Allowed Amount |
129472.22 |
Total Medical Medicare Payment Amount |
99934.92 |
Total Medical Medicare Standardized Payment Amount |
99738.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
91 |
Number Of Male Beneficiaries |
109 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9695 |