National Provider Identifier [NPI]: |
1750397923 |
Last Name Of The Provider |
KORDUNSKY |
First Name Of The Provider |
LANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 CENTRE ST |
Street Address 2 Of The Provider |
SIGNATURE HEALTHCARE BROCKTON HOSPITAL, PATHOLOGY DPT. |
City Of The Provider |
BROCKTON |
Zip Code Of The Provider |
023023308 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1926 |
Number Of Medicare Beneficiaries |
796 |
Total Submitted Charge Amount |
285612 |
Total Medicare Allowed Amount |
66090.14 |
Total Medicare Payment Amount |
49845 |
Total Medicare Standardized Payment Amount |
36744.98 |
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 |
25 |
Number Of Medical Services |
1926 |
Number Of Medicare Beneficiaries With Medical Services |
796 |
Total Medical Submitted Charge Amount |
285612 |
Total Medical Medicare Allowed Amount |
66090.14 |
Total Medical Medicare Payment Amount |
49845 |
Total Medical Medicare Standardized Payment Amount |
36744.98 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
284 |
Number Of Beneficiaries Age 65 to 74 |
332 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
486 |
Number Of Male Beneficiaries |
310 |
Number Of Non Hispanic White Beneficiaries |
637 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
368 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4124 |