National Provider Identifier [NPI]: |
1366679649 |
Last Name Of The Provider |
TAPPER |
First Name Of The Provider |
ELLIOT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 BROOKLINE AVE |
Street Address 2 Of The Provider |
DEACONESS 307 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
022155400 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
107 |
Number Of Medicare Beneficiaries |
51 |
Total Submitted Charge Amount |
33694 |
Total Medicare Allowed Amount |
11234.3 |
Total Medicare Payment Amount |
8408.71 |
Total Medicare Standardized Payment Amount |
8423.1 |
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 |
107 |
Number Of Medicare Beneficiaries With Medical Services |
51 |
Total Medical Submitted Charge Amount |
33694 |
Total Medical Medicare Allowed Amount |
11234.3 |
Total Medical Medicare Payment Amount |
8408.71 |
Total Medical Medicare Standardized Payment Amount |
8423.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
12 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
27 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
31 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.951 |