National Provider Identifier [NPI]: |
1033347216 |
Last Name Of The Provider |
BHUGRA |
First Name Of The Provider |
MUDITA |
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 |
4 GLEN COVE DR |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
ROCKPORT |
Zip Code Of The Provider |
048564235 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
725 |
Number Of Medicare Beneficiaries |
339 |
Total Submitted Charge Amount |
54577 |
Total Medicare Allowed Amount |
50301.1 |
Total Medicare Payment Amount |
39095.72 |
Total Medicare Standardized Payment Amount |
41396.23 |
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 |
21 |
Number Of Medical Services |
725 |
Number Of Medicare Beneficiaries With Medical Services |
339 |
Total Medical Submitted Charge Amount |
54577 |
Total Medical Medicare Allowed Amount |
50301.1 |
Total Medical Medicare Payment Amount |
39095.72 |
Total Medical Medicare Standardized Payment Amount |
41396.23 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
131 |
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 |
197 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1135 |