National Provider Identifier [NPI]: |
1174624753 |
Last Name Of The Provider |
BURLEY |
First Name Of The Provider |
MARGARET |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
RN, PC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 SOUTH ST |
Street Address 2 Of The Provider |
HARRINGTON MEMORIAL HOSPITAL |
City Of The Provider |
SOUTHBRIDGE |
Zip Code Of The Provider |
015504051 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
106 |
Number Of Medicare Beneficiaries |
28 |
Total Submitted Charge Amount |
13302 |
Total Medicare Allowed Amount |
7526.47 |
Total Medicare Payment Amount |
5685.51 |
Total Medicare Standardized Payment Amount |
6643.76 |
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 |
3 |
Number Of Medical Services |
106 |
Number Of Medicare Beneficiaries With Medical Services |
28 |
Total Medical Submitted Charge Amount |
13302 |
Total Medical Medicare Allowed Amount |
7526.47 |
Total Medical Medicare Payment Amount |
5685.51 |
Total Medical Medicare Standardized Payment Amount |
6643.76 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
16 |
Number Of Male Beneficiaries |
12 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
75 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
64 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9738 |