National Provider Identifier [NPI]: |
1881670842 |
Last Name Of The Provider |
WINGROVE |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
690 CANTON ST |
Street Address 2 Of The Provider |
SUITE 325 |
City Of The Provider |
WESTWOOD |
Zip Code Of The Provider |
020902321 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
405 |
Number Of Medicare Beneficiaries |
321 |
Total Submitted Charge Amount |
468201 |
Total Medicare Allowed Amount |
67753.39 |
Total Medicare Payment Amount |
52849.84 |
Total Medicare Standardized Payment Amount |
52716.22 |
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 |
76 |
Number Of Medical Services |
405 |
Number Of Medicare Beneficiaries With Medical Services |
321 |
Total Medical Submitted Charge Amount |
468201 |
Total Medical Medicare Allowed Amount |
67753.39 |
Total Medical Medicare Payment Amount |
52849.84 |
Total Medical Medicare Standardized Payment Amount |
52716.22 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
284 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3995 |