National Provider Identifier [NPI]: |
1578673190 |
Last Name Of The Provider |
TANG |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 GROSSMAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRAINTREE |
Zip Code Of The Provider |
021844997 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
6974 |
Number Of Medicare Beneficiaries |
756 |
Total Submitted Charge Amount |
741559 |
Total Medicare Allowed Amount |
362510.2 |
Total Medicare Payment Amount |
268285.63 |
Total Medicare Standardized Payment Amount |
245897.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
72 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
13868 |
Total Drug Medicare AllowedAmount |
12586.37 |
Total Drug Medicare PaymentAmount |
9876.44 |
Total Drug Medicare Standardized Payment Amount |
9876.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
6902 |
Number Of Medicare Beneficiaries With Medical Services |
756 |
Total Medical Submitted Charge Amount |
727691 |
Total Medical Medicare Allowed Amount |
349923.83 |
Total Medical Medicare Payment Amount |
258409.19 |
Total Medical Medicare Standardized Payment Amount |
236021.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
373 |
Number Of Beneficiaries Age 75 to 84 |
247 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
399 |
Number Of Male Beneficiaries |
357 |
Number Of Non Hispanic White Beneficiaries |
724 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
720 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9467 |