National Provider Identifier [NPI]: |
1447274360 |
Last Name Of The Provider |
BUSHNELL |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
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 |
FAHC, EMERGENCY DEPARTMENT |
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 |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
922 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
528853 |
Total Medicare Allowed Amount |
93106.51 |
Total Medicare Payment Amount |
69191.62 |
Total Medicare Standardized Payment Amount |
71352.55 |
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 |
32 |
Number Of Medical Services |
922 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
528853 |
Total Medical Medicare Allowed Amount |
93106.51 |
Total Medical Medicare Payment Amount |
69191.62 |
Total Medical Medicare Standardized Payment Amount |
71352.55 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
483 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
277 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
251 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.735 |