National Provider Identifier [NPI]: |
1790782852 |
Last Name Of The Provider |
BAKER-BERZANSKY |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 WATER ST |
Street Address 2 Of The Provider |
CENTRAL PLAZA |
City Of The Provider |
HAVERHILL |
Zip Code Of The Provider |
018306223 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
747 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
204927 |
Total Medicare Allowed Amount |
61693.39 |
Total Medicare Payment Amount |
47489.43 |
Total Medicare Standardized Payment Amount |
47730.07 |
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 |
51 |
Number Of Medical Services |
747 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
204927 |
Total Medical Medicare Allowed Amount |
61693.39 |
Total Medical Medicare Payment Amount |
47489.43 |
Total Medical Medicare Standardized Payment Amount |
47730.07 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
145 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
281 |
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 |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
4 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8344 |