National Provider Identifier [NPI]: |
1255366449 |
Last Name Of The Provider |
BRUNDAGE |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
WEST PAVILION-LEVEL 4 |
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
1012 |
Number Of Medicare Beneficiaries |
415 |
Total Submitted Charge Amount |
636567 |
Total Medicare Allowed Amount |
116917.08 |
Total Medicare Payment Amount |
88119.56 |
Total Medicare Standardized Payment Amount |
89928.27 |
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 |
105 |
Number Of Medical Services |
1012 |
Number Of Medicare Beneficiaries With Medical Services |
415 |
Total Medical Submitted Charge Amount |
636567 |
Total Medical Medicare Allowed Amount |
116917.08 |
Total Medical Medicare Payment Amount |
88119.56 |
Total Medical Medicare Standardized Payment Amount |
89928.27 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
397 |
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 |
333 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2104 |