National Provider Identifier [NPI]: |
1770711160 |
Last Name Of The Provider |
BAILEY |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
185 PILGRIM RD |
Street Address 2 Of The Provider |
DEACONESS 306 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
022155324 |
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 |
10 |
Number Of Services |
380 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
88381 |
Total Medicare Allowed Amount |
29359.86 |
Total Medicare Payment Amount |
22245.5 |
Total Medicare Standardized Payment Amount |
22013.06 |
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 |
10 |
Number Of Medical Services |
380 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
88381 |
Total Medical Medicare Allowed Amount |
29359.86 |
Total Medical Medicare Payment Amount |
22245.5 |
Total Medical Medicare Standardized Payment Amount |
22013.06 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
111 |
Number Of Black or African American Beneficiaries |
22 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.8801 |