National Provider Identifier [NPI]: |
1659362010 |
Last Name Of The Provider |
LEEDS |
First Name Of The Provider |
NAOMI |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 PARKMAN ST |
Street Address 2 Of The Provider |
WAC 615 INTERNAL MEDICINE ASSOCIATES TEAM 2 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021143117 |
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 |
13 |
Number Of Services |
738 |
Number Of Medicare Beneficiaries |
413 |
Total Submitted Charge Amount |
175417 |
Total Medicare Allowed Amount |
54284.65 |
Total Medicare Payment Amount |
39293.82 |
Total Medicare Standardized Payment Amount |
37739.52 |
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 |
13 |
Number Of Medical Services |
738 |
Number Of Medicare Beneficiaries With Medical Services |
413 |
Total Medical Submitted Charge Amount |
175417 |
Total Medical Medicare Allowed Amount |
54284.65 |
Total Medical Medicare Payment Amount |
39293.82 |
Total Medical Medicare Standardized Payment Amount |
37739.52 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
271 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
331 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
288 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2149 |