National Provider Identifier [NPI]: |
1194795781 |
Last Name Of The Provider |
FERRANTE |
First Name Of The Provider |
MARYBETH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
625 MOUNT AUBURN ST |
Street Address 2 Of The Provider |
STE 104 |
City Of The Provider |
CAMBRIDGE |
Zip Code Of The Provider |
021384555 |
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 |
32 |
Number Of Services |
449 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
36863 |
Total Medicare Allowed Amount |
20465.07 |
Total Medicare Payment Amount |
15412.82 |
Total Medicare Standardized Payment Amount |
14419.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
1156 |
Total Drug Medicare AllowedAmount |
684.47 |
Total Drug Medicare PaymentAmount |
669.21 |
Total Drug Medicare Standardized Payment Amount |
669.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
415 |
Number Of Medicare Beneficiaries With Medical Services |
77 |
Total Medical Submitted Charge Amount |
35707 |
Total Medical Medicare Allowed Amount |
19780.6 |
Total Medical Medicare Payment Amount |
14743.61 |
Total Medical Medicare Standardized Payment Amount |
13750.71 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
65 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
63 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.198 |