National Provider Identifier [NPI]: |
1710997481 |
Last Name Of The Provider |
LEARY |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 COLLINS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRISTOL |
Zip Code Of The Provider |
06010 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
178 |
Number Of Services |
9325 |
Number Of Medicare Beneficiaries |
2563 |
Total Submitted Charge Amount |
1115612.5 |
Total Medicare Allowed Amount |
299750.1 |
Total Medicare Payment Amount |
238983.11 |
Total Medicare Standardized Payment Amount |
222871.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
4482 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
4754.5 |
Total Drug Medicare AllowedAmount |
1805.21 |
Total Drug Medicare PaymentAmount |
1402.41 |
Total Drug Medicare Standardized Payment Amount |
1402.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
176 |
Number Of Medical Services |
4843 |
Number Of Medicare Beneficiaries With Medical Services |
2563 |
Total Medical Submitted Charge Amount |
1110858 |
Total Medical Medicare Allowed Amount |
297944.89 |
Total Medical Medicare Payment Amount |
237580.7 |
Total Medical Medicare Standardized Payment Amount |
221468.75 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
528 |
Number Of Beneficiaries Age 65 to 74 |
849 |
Number Of Beneficiaries Age 75 to 84 |
698 |
Number Of Beneficiaries Age Greater 84 |
488 |
Number Of Female Beneficiaries |
1709 |
Number Of Male Beneficiaries |
854 |
Number Of Non Hispanic White Beneficiaries |
2349 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
97 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
35 |
Number Of Beneficiaries With Medicare Only Entitlement |
1576 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
987 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4645 |