National Provider Identifier [NPI]: |
1336188333 |
Last Name Of The Provider |
GREGG |
First Name Of The Provider |
KRISTIN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 BREWSTER STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
PAWTUCKET |
Zip Code Of The Provider |
028604400 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
336 |
Number Of Medicare Beneficiaries |
262 |
Total Submitted Charge Amount |
262590 |
Total Medicare Allowed Amount |
37907.07 |
Total Medicare Payment Amount |
29669.84 |
Total Medicare Standardized Payment Amount |
28225.04 |
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 |
13 |
Number Of Medical Services |
336 |
Number Of Medicare Beneficiaries With Medical Services |
262 |
Total Medical Submitted Charge Amount |
262590 |
Total Medical Medicare Allowed Amount |
37907.07 |
Total Medical Medicare Payment Amount |
29669.84 |
Total Medical Medicare Standardized Payment Amount |
28225.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
55 |
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 |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4631 |