National Provider Identifier [NPI]: |
1265457675 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
135 PLEASANT ST |
Street Address 2 Of The Provider |
APT 206 |
City Of The Provider |
BROOKLINE |
Zip Code Of The Provider |
024467142 |
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 |
12 |
Number Of Services |
1649 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
458017 |
Total Medicare Allowed Amount |
145882.23 |
Total Medicare Payment Amount |
113267.93 |
Total Medicare Standardized Payment Amount |
108954.83 |
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 |
12 |
Number Of Medical Services |
1649 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
458017 |
Total Medical Medicare Allowed Amount |
145882.23 |
Total Medical Medicare Payment Amount |
113267.93 |
Total Medical Medicare Standardized Payment Amount |
108954.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
4.1659 |