National Provider Identifier [NPI]: |
1528119559 |
Last Name Of The Provider |
GIBBONS |
First Name Of The Provider |
SEAN |
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 |
281 LINCOLN ST |
Street Address 2 Of The Provider |
MED STAFF SVCS |
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
016052138 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
340 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
397872.96 |
Total Medicare Allowed Amount |
52537.03 |
Total Medicare Payment Amount |
41073.86 |
Total Medicare Standardized Payment Amount |
41206.02 |
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 |
66 |
Number Of Medical Services |
340 |
Number Of Medicare Beneficiaries With Medical Services |
322 |
Total Medical Submitted Charge Amount |
397872.96 |
Total Medical Medicare Allowed Amount |
52537.03 |
Total Medical Medicare Payment Amount |
41073.86 |
Total Medical Medicare Standardized Payment Amount |
41206.02 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
304 |
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 |
269 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.3247 |