National Provider Identifier [NPI]: |
1992775290 |
Last Name Of The Provider |
ANDREWS |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
263 FARMINGTON AVE |
Street Address 2 Of The Provider |
GEN MED CLINIC |
City Of The Provider |
FARMINGTON |
Zip Code Of The Provider |
060300001 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
461 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
61832 |
Total Medicare Allowed Amount |
32121.04 |
Total Medicare Payment Amount |
24360.08 |
Total Medicare Standardized Payment Amount |
22747.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2687 |
Total Drug Medicare AllowedAmount |
1264.16 |
Total Drug Medicare PaymentAmount |
1229.09 |
Total Drug Medicare Standardized Payment Amount |
1229.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
407 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
59145 |
Total Medical Medicare Allowed Amount |
30856.88 |
Total Medical Medicare Payment Amount |
23130.99 |
Total Medical Medicare Standardized Payment Amount |
21518.09 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
97 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4083 |