National Provider Identifier [NPI]: |
1164457875 |
Last Name Of The Provider |
SHROFF |
First Name Of The Provider |
SUNIL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 WASHINGTON ST |
Street Address 2 Of The Provider |
BOX #311 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021111552 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
563 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
268123 |
Total Medicare Allowed Amount |
69224.23 |
Total Medicare Payment Amount |
53960.17 |
Total Medicare Standardized Payment Amount |
52937.02 |
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 |
33 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
426 |
Total Medical Submitted Charge Amount |
268123 |
Total Medical Medicare Allowed Amount |
69224.23 |
Total Medical Medicare Payment Amount |
53960.17 |
Total Medical Medicare Standardized Payment Amount |
52937.02 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
224 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
272 |
Number Of Black or African American Beneficiaries |
76 |
Number Of AsianPacific Islander Beneficiaries |
30 |
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.212 |