National Provider Identifier [NPI]: |
1225050123 |
Last Name Of The Provider |
PINCKNEY |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 S PROSPECT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054013456 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
546 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
48200 |
Total Medicare Allowed Amount |
33741.83 |
Total Medicare Payment Amount |
24855.47 |
Total Medicare Standardized Payment Amount |
25363.06 |
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 |
22 |
Number Of Medical Services |
546 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
48200 |
Total Medical Medicare Allowed Amount |
33741.83 |
Total Medical Medicare Payment Amount |
24855.47 |
Total Medical Medicare Standardized Payment Amount |
25363.06 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1021 |