National Provider Identifier [NPI]: |
1407837818 |
Last Name Of The Provider |
BURNETT |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT ST |
Street Address 2 Of The Provider |
YAW 6800 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142621 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
614 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
120975 |
Total Medicare Allowed Amount |
43232.22 |
Total Medicare Payment Amount |
31777.32 |
Total Medicare Standardized Payment Amount |
28962.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
2325 |
Total Drug Medicare AllowedAmount |
1483.36 |
Total Drug Medicare PaymentAmount |
1047.69 |
Total Drug Medicare Standardized Payment Amount |
1047.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
118650 |
Total Medical Medicare Allowed Amount |
41748.86 |
Total Medical Medicare Payment Amount |
30729.63 |
Total Medical Medicare Standardized Payment Amount |
27914.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
22 |
Percent Of With Diabetes |
10 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9073 |