National Provider Identifier [NPI]: |
1093046401 |
Last Name Of The Provider |
KOTSINYAN |
First Name Of The Provider |
VAHAGN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 ELLIOT WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
031033502 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
1255 |
Number Of Medicare Beneficiaries |
583 |
Total Submitted Charge Amount |
268921 |
Total Medicare Allowed Amount |
136026.06 |
Total Medicare Payment Amount |
106318.8 |
Total Medicare Standardized Payment Amount |
105496.04 |
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 |
14 |
Number Of Medical Services |
1255 |
Number Of Medicare Beneficiaries With Medical Services |
583 |
Total Medical Submitted Charge Amount |
268921 |
Total Medical Medicare Allowed Amount |
136026.06 |
Total Medical Medicare Payment Amount |
106318.8 |
Total Medical Medicare Standardized Payment Amount |
105496.04 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
359 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
564 |
Number Of Black or African American Beneficiaries |
|
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 |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0221 |