National Provider Identifier [NPI]: |
1083683130 |
Last Name Of The Provider |
SPRUIELL |
First Name Of The Provider |
GRAHAM |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
VALLEY REGIONAL MEDICAL SERVICES |
Street Address 2 Of The Provider |
70 EAST STREET |
City Of The Provider |
METHUEN |
Zip Code Of The Provider |
01844 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
832 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
125258 |
Total Medicare Allowed Amount |
79961.27 |
Total Medicare Payment Amount |
62168.55 |
Total Medicare Standardized Payment Amount |
61230.21 |
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 |
6 |
Number Of Medical Services |
832 |
Number Of Medicare Beneficiaries With Medical Services |
190 |
Total Medical Submitted Charge Amount |
125258 |
Total Medical Medicare Allowed Amount |
79961.27 |
Total Medical Medicare Payment Amount |
62168.55 |
Total Medical Medicare Standardized Payment Amount |
61230.21 |
Average Age Of Beneficiaries |
47 |
Number Of Beneficiaries Age Less65 |
176 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
77 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
20 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
26 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
18 |
Percent Of With Schizophrenia Other PsychoticDisorders |
49 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4659 |