National Provider Identifier [NPI]: |
1023125481 |
Last Name Of The Provider |
KOPELMAN |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
750 WASHINGTON ST |
Street Address 2 Of The Provider |
NEMC BOX 836 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021111526 |
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 |
16 |
Number Of Services |
705 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
190497 |
Total Medicare Allowed Amount |
67956.51 |
Total Medicare Payment Amount |
51240.85 |
Total Medicare Standardized Payment Amount |
49229.37 |
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 |
16 |
Number Of Medical Services |
705 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
190497 |
Total Medical Medicare Allowed Amount |
67956.51 |
Total Medical Medicare Payment Amount |
51240.85 |
Total Medical Medicare Standardized Payment Amount |
49229.37 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
228 |
Number Of Black or African American Beneficiaries |
27 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.389 |