National Provider Identifier [NPI]: |
1366637761 |
Last Name Of The Provider |
LIAN |
First Name Of The Provider |
BILL |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 LAKE AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
016550002 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
527 |
Number Of Medicare Beneficiaries |
269 |
Total Submitted Charge Amount |
156458 |
Total Medicare Allowed Amount |
41902.51 |
Total Medicare Payment Amount |
28965.98 |
Total Medicare Standardized Payment Amount |
30266.9 |
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 |
13 |
Number Of Medical Services |
527 |
Number Of Medicare Beneficiaries With Medical Services |
269 |
Total Medical Submitted Charge Amount |
156458 |
Total Medical Medicare Allowed Amount |
41902.51 |
Total Medical Medicare Payment Amount |
28965.98 |
Total Medical Medicare Standardized Payment Amount |
30266.9 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.347 |