National Provider Identifier [NPI]: |
1669433413 |
Last Name Of The Provider |
PIERSON |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1665 |
Number Of Medicare Beneficiaries |
653 |
Total Submitted Charge Amount |
100689 |
Total Medicare Allowed Amount |
71703.67 |
Total Medicare Payment Amount |
52845.67 |
Total Medicare Standardized Payment Amount |
54011.61 |
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 |
39 |
Number Of Medical Services |
1665 |
Number Of Medicare Beneficiaries With Medical Services |
653 |
Total Medical Submitted Charge Amount |
100689 |
Total Medical Medicare Allowed Amount |
71703.67 |
Total Medical Medicare Payment Amount |
52845.67 |
Total Medical Medicare Standardized Payment Amount |
54011.61 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
320 |
Number Of Non Hispanic White Beneficiaries |
629 |
Number Of Black or African American Beneficiaries |
|
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
501 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1108 |