National Provider Identifier [NPI]: |
1790888360 |
Last Name Of The Provider |
DONAHUE |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 WEST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILFORD |
Zip Code Of The Provider |
01757 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
961 |
Number Of Medicare Beneficiaries |
502 |
Total Submitted Charge Amount |
778225 |
Total Medicare Allowed Amount |
149788.93 |
Total Medicare Payment Amount |
115828.69 |
Total Medicare Standardized Payment Amount |
116514.97 |
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 |
40 |
Number Of Medical Services |
961 |
Number Of Medicare Beneficiaries With Medical Services |
502 |
Total Medical Submitted Charge Amount |
778225 |
Total Medical Medicare Allowed Amount |
149788.93 |
Total Medical Medicare Payment Amount |
115828.69 |
Total Medical Medicare Standardized Payment Amount |
116514.97 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
273 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
478 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
390 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.319 |