National Provider Identifier [NPI]: |
1245211960 |
Last Name Of The Provider |
LIN |
First Name Of The Provider |
HERBERT |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT STREET |
Street Address 2 Of The Provider |
RENAL ASSOCIATES |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142696 |
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 |
36 |
Number Of Services |
2181 |
Number Of Medicare Beneficiaries |
784 |
Total Submitted Charge Amount |
654684.72 |
Total Medicare Allowed Amount |
214028.61 |
Total Medicare Payment Amount |
164284.83 |
Total Medicare Standardized Payment Amount |
154270.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
1004 |
Total Drug Medicare AllowedAmount |
741.85 |
Total Drug Medicare PaymentAmount |
726.46 |
Total Drug Medicare Standardized Payment Amount |
726.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2156 |
Number Of Medicare Beneficiaries With Medical Services |
784 |
Total Medical Submitted Charge Amount |
653680.72 |
Total Medical Medicare Allowed Amount |
213286.76 |
Total Medical Medicare Payment Amount |
163558.37 |
Total Medical Medicare Standardized Payment Amount |
153543.73 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
159 |
Number Of Beneficiaries Age 65 to 74 |
289 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
325 |
Number Of Male Beneficiaries |
459 |
Number Of Non Hispanic White Beneficiaries |
643 |
Number Of Black or African American Beneficiaries |
57 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
543 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
241 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
70 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.8242 |