National Provider Identifier [NPI]: |
1588776173 |
Last Name Of The Provider |
OLIN |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 HIGH RIDGE PARK |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
STAMFORD |
Zip Code Of The Provider |
069051332 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1777 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
185595.05 |
Total Medicare Allowed Amount |
102007.08 |
Total Medicare Payment Amount |
78431.03 |
Total Medicare Standardized Payment Amount |
73558.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
125 |
Number Of Medicare Beneficiaries With Drug Services |
74 |
Total Drug Submitted ChargeAmount |
5690.05 |
Total Drug Medicare AllowedAmount |
3987.35 |
Total Drug Medicare PaymentAmount |
3883 |
Total Drug Medicare Standardized Payment Amount |
3883 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1652 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
179905 |
Total Medical Medicare Allowed Amount |
98019.73 |
Total Medical Medicare Payment Amount |
74548.03 |
Total Medical Medicare Standardized Payment Amount |
69675.95 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3734 |