National Provider Identifier [NPI]: |
1417966557 |
Last Name Of The Provider |
LIU |
First Name Of The Provider |
MINPING |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
SOUTH COVE COMMUNITY HEALTH CENTER |
Street Address 2 Of The Provider |
885 WASHINGTON STREET |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
02111 |
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 |
11 |
Number Of Services |
593 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
17549.4 |
Total Medicare Allowed Amount |
8953.12 |
Total Medicare Payment Amount |
8083.08 |
Total Medicare Standardized Payment Amount |
7626.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
2688.4 |
Total Drug Medicare AllowedAmount |
2063.82 |
Total Drug Medicare PaymentAmount |
1996.45 |
Total Drug Medicare Standardized Payment Amount |
1996.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
512 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
14861 |
Total Medical Medicare Allowed Amount |
6889.3 |
Total Medical Medicare Payment Amount |
6086.63 |
Total Medical Medicare Standardized Payment Amount |
5629.69 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
93 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
244 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
10 |
Percent Of With Osteoporosis |
28 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
12 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9831 |