National Provider Identifier [NPI]: |
1043240476 |
Last Name Of The Provider |
MAHONEY |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2110 DORCHESTER AVE |
Street Address 2 Of The Provider |
SETON MEDICAL BUILDING |
City Of The Provider |
DORCHESTER CENTER |
Zip Code Of The Provider |
021245628 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
691 |
Number Of Medicare Beneficiaries |
454 |
Total Submitted Charge Amount |
159920 |
Total Medicare Allowed Amount |
71206.79 |
Total Medicare Payment Amount |
51043.99 |
Total Medicare Standardized Payment Amount |
49311.2 |
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 |
18 |
Number Of Medical Services |
691 |
Number Of Medicare Beneficiaries With Medical Services |
454 |
Total Medical Submitted Charge Amount |
159920 |
Total Medical Medicare Allowed Amount |
71206.79 |
Total Medical Medicare Payment Amount |
51043.99 |
Total Medical Medicare Standardized Payment Amount |
49311.2 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
275 |
Number Of Male Beneficiaries |
179 |
Number Of Non Hispanic White Beneficiaries |
393 |
Number Of Black or African American Beneficiaries |
42 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
342 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
1.5685 |