National Provider Identifier [NPI]: |
1518948496 |
Last Name Of The Provider |
WARNICK |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 LIBERTY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROCKTON |
Zip Code Of The Provider |
023015521 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
3305 |
Number Of Medicare Beneficiaries |
457 |
Total Submitted Charge Amount |
417000 |
Total Medicare Allowed Amount |
186157.65 |
Total Medicare Payment Amount |
134730.53 |
Total Medicare Standardized Payment Amount |
131052.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
212 |
Number Of Medicare Beneficiaries With Drug Services |
188 |
Total Drug Submitted ChargeAmount |
11200 |
Total Drug Medicare AllowedAmount |
7940.29 |
Total Drug Medicare PaymentAmount |
7721.77 |
Total Drug Medicare Standardized Payment Amount |
7721.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
3093 |
Number Of Medicare Beneficiaries With Medical Services |
457 |
Total Medical Submitted Charge Amount |
405800 |
Total Medical Medicare Allowed Amount |
178217.36 |
Total Medical Medicare Payment Amount |
127008.76 |
Total Medical Medicare Standardized Payment Amount |
123330.84 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
231 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
238 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
396 |
Number Of Black or African American Beneficiaries |
30 |
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 |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0377 |