National Provider Identifier [NPI]: |
1215151329 |
Last Name Of The Provider |
TOBA |
First Name Of The Provider |
CRISTINA |
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 |
146 W RIVER ST |
Street Address 2 Of The Provider |
SUITE 11B |
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029042609 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
398 |
Number Of Medicare Beneficiaries |
95 |
Total Submitted Charge Amount |
60285 |
Total Medicare Allowed Amount |
42342.34 |
Total Medicare Payment Amount |
29504.66 |
Total Medicare Standardized Payment Amount |
31187.73 |
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 |
11 |
Number Of Medical Services |
398 |
Number Of Medicare Beneficiaries With Medical Services |
95 |
Total Medical Submitted Charge Amount |
60285 |
Total Medical Medicare Allowed Amount |
42342.34 |
Total Medical Medicare Payment Amount |
29504.66 |
Total Medical Medicare Standardized Payment Amount |
31187.73 |
Average Age Of Beneficiaries |
57 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
72 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
54 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1601 |