National Provider Identifier [NPI]: |
1932189693 |
Last Name Of The Provider |
NASHID |
First Name Of The Provider |
NADIA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
112 MANSFIELD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLIMANTIC |
Zip Code Of The Provider |
062262041 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1500 |
Number Of Medicare Beneficiaries |
602 |
Total Submitted Charge Amount |
236970 |
Total Medicare Allowed Amount |
60296.48 |
Total Medicare Payment Amount |
46868.29 |
Total Medicare Standardized Payment Amount |
35965.2 |
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 |
20 |
Number Of Medical Services |
1500 |
Number Of Medicare Beneficiaries With Medical Services |
602 |
Total Medical Submitted Charge Amount |
236970 |
Total Medical Medicare Allowed Amount |
60296.48 |
Total Medical Medicare Payment Amount |
46868.29 |
Total Medical Medicare Standardized Payment Amount |
35965.2 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
536 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
171 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4127 |