National Provider Identifier [NPI]: |
1376773754 |
Last Name Of The Provider |
SPERRY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021111552 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
385 |
Number Of Medicare Beneficiaries |
126 |
Total Submitted Charge Amount |
69010 |
Total Medicare Allowed Amount |
34926.96 |
Total Medicare Payment Amount |
27382.83 |
Total Medicare Standardized Payment Amount |
26999.15 |
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 |
11 |
Number Of Medical Services |
385 |
Number Of Medicare Beneficiaries With Medical Services |
126 |
Total Medical Submitted Charge Amount |
69010 |
Total Medical Medicare Allowed Amount |
34926.96 |
Total Medical Medicare Payment Amount |
27382.83 |
Total Medical Medicare Standardized Payment Amount |
26999.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
3.1411 |