National Provider Identifier [NPI]: |
1891729976 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
85 BEACH STREET |
Street Address 2 Of The Provider |
BLDG C |
City Of The Provider |
WESTERLY |
Zip Code Of The Provider |
02891 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
3789 |
Number Of Medicare Beneficiaries |
990 |
Total Submitted Charge Amount |
215338 |
Total Medicare Allowed Amount |
166171.5 |
Total Medicare Payment Amount |
115455.55 |
Total Medicare Standardized Payment Amount |
111002.7 |
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 |
26 |
Number Of Medical Services |
3789 |
Number Of Medicare Beneficiaries With Medical Services |
990 |
Total Medical Submitted Charge Amount |
215338 |
Total Medical Medicare Allowed Amount |
166171.5 |
Total Medical Medicare Payment Amount |
115455.55 |
Total Medical Medicare Standardized Payment Amount |
111002.7 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
342 |
Number Of Beneficiaries Age Greater 84 |
369 |
Number Of Female Beneficiaries |
561 |
Number Of Male Beneficiaries |
429 |
Number Of Non Hispanic White Beneficiaries |
964 |
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 |
887 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5909 |