National Provider Identifier [NPI]: |
1184868069 |
Last Name Of The Provider |
LOOMIS |
First Name Of The Provider |
CAITLIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 YORK ST |
Street Address 2 Of The Provider |
LCI 912 |
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
06520 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
199 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
72620 |
Total Medicare Allowed Amount |
23566.11 |
Total Medicare Payment Amount |
18476.37 |
Total Medicare Standardized Payment Amount |
17425.47 |
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 |
15 |
Number Of Medical Services |
199 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
72620 |
Total Medical Medicare Allowed Amount |
23566.11 |
Total Medical Medicare Payment Amount |
18476.37 |
Total Medical Medicare Standardized Payment Amount |
17425.47 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
87 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
75 |
Average HCC Risk Score Of Beneficiaries |
1.8816 |