National Provider Identifier [NPI]: |
1356437081 |
Last Name Of The Provider |
O'BRIEN |
First Name Of The Provider |
MARTHA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 STANIFORD ST |
Street Address 2 Of The Provider |
C/O MA ANESTHESIA CORP |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
02115 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
563 |
Number Of Medicare Beneficiaries |
519 |
Total Submitted Charge Amount |
509630 |
Total Medicare Allowed Amount |
50177.04 |
Total Medicare Payment Amount |
38590.23 |
Total Medicare Standardized Payment Amount |
38160.47 |
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 |
6 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
519 |
Total Medical Submitted Charge Amount |
509630 |
Total Medical Medicare Allowed Amount |
50177.04 |
Total Medical Medicare Payment Amount |
38590.23 |
Total Medical Medicare Standardized Payment Amount |
38160.47 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
326 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
488 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
493 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0573 |