National Provider Identifier [NPI]: |
1346275716 |
Last Name Of The Provider |
CHAPMAN |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18 OLD ETNA RD |
Street Address 2 Of The Provider |
DEPARTMENT OF GENERAL INTERNAL MEDICINE |
City Of The Provider |
LEBANON |
Zip Code Of The Provider |
03766 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
418 |
Number Of Medicare Beneficiaries |
334 |
Total Submitted Charge Amount |
36390.95 |
Total Medicare Allowed Amount |
24217.97 |
Total Medicare Payment Amount |
17447.7 |
Total Medicare Standardized Payment Amount |
20817.99 |
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 |
418 |
Number Of Medicare Beneficiaries With Medical Services |
334 |
Total Medical Submitted Charge Amount |
36390.95 |
Total Medical Medicare Allowed Amount |
24217.97 |
Total Medical Medicare Payment Amount |
17447.7 |
Total Medical Medicare Standardized Payment Amount |
20817.99 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
312 |
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9713 |