National Provider Identifier [NPI]: |
1174533061 |
Last Name Of The Provider |
MARSHALL |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 ASYLUM AVE |
Street Address 2 Of The Provider |
SUITE 4320 |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
061051770 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
940 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
368657 |
Total Medicare Allowed Amount |
160240.86 |
Total Medicare Payment Amount |
124523.51 |
Total Medicare Standardized Payment Amount |
116970.37 |
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 |
91 |
Number Of Medical Services |
940 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
368657 |
Total Medical Medicare Allowed Amount |
160240.86 |
Total Medical Medicare Payment Amount |
124523.51 |
Total Medical Medicare Standardized Payment Amount |
116970.37 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
175 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
52 |
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 |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9758 |