National Provider Identifier [NPI]: |
1699905091 |
Last Name Of The Provider |
BU |
First Name Of The Provider |
JING |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 NORTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PITTSFIELD |
Zip Code Of The Provider |
012012142 |
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 |
16 |
Number Of Services |
318 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
36683.05 |
Total Medicare Allowed Amount |
19398.75 |
Total Medicare Payment Amount |
15286.29 |
Total Medicare Standardized Payment Amount |
15121.11 |
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 |
16 |
Number Of Medical Services |
318 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
36683.05 |
Total Medical Medicare Allowed Amount |
19398.75 |
Total Medical Medicare Payment Amount |
15286.29 |
Total Medical Medicare Standardized Payment Amount |
15121.11 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
54 |
Number Of Non Hispanic White Beneficiaries |
128 |
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 |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
65 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
75 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9699 |