National Provider Identifier [NPI]: |
1619196755 |
Last Name Of The Provider |
DONALDSON |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
68 CUMBERLAND ST |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
WOONSOCKET |
Zip Code Of The Provider |
028953323 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
2179 |
Number Of Medicare Beneficiaries |
563 |
Total Submitted Charge Amount |
405171.6 |
Total Medicare Allowed Amount |
194269.05 |
Total Medicare Payment Amount |
147119.76 |
Total Medicare Standardized Payment Amount |
145605.4 |
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 |
72 |
Number Of Medical Services |
2179 |
Number Of Medicare Beneficiaries With Medical Services |
563 |
Total Medical Submitted Charge Amount |
405171.6 |
Total Medical Medicare Allowed Amount |
194269.05 |
Total Medical Medicare Payment Amount |
147119.76 |
Total Medical Medicare Standardized Payment Amount |
145605.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
283 |
Number Of Non Hispanic White Beneficiaries |
495 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0258 |