National Provider Identifier [NPI]: |
1124260187 |
Last Name Of The Provider |
BUGAEV |
First Name Of The Provider |
NIKOLAY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 WASHINGTON STREET |
Street Address 2 Of The Provider |
|
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 |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
236199 |
Total Medicare Allowed Amount |
70859.69 |
Total Medicare Payment Amount |
54482.38 |
Total Medicare Standardized Payment Amount |
53574.8 |
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 |
70 |
Number Of Medical Services |
275 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
236199 |
Total Medical Medicare Allowed Amount |
70859.69 |
Total Medical Medicare Payment Amount |
54482.38 |
Total Medical Medicare Standardized Payment Amount |
53574.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
17 |
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 |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2462 |