National Provider Identifier [NPI]: |
1992787915 |
Last Name Of The Provider |
CHO |
First Name Of The Provider |
TRACEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT ST |
Street Address 2 Of The Provider |
WAC 835 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142621 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
172210 |
Total Medicare Allowed Amount |
51417.26 |
Total Medicare Payment Amount |
38442.2 |
Total Medicare Standardized Payment Amount |
36869.77 |
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 |
13 |
Number Of Medical Services |
466 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
172210 |
Total Medical Medicare Allowed Amount |
51417.26 |
Total Medical Medicare Payment Amount |
38442.2 |
Total Medical Medicare Standardized Payment Amount |
36869.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
36 |
Average HCC Risk Score Of Beneficiaries |
1.6486 |