National Provider Identifier [NPI]: |
1376582445 |
Last Name Of The Provider |
FECTEAU |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 ASYLUM AVE |
Street Address 2 Of The Provider |
SUITE 2120 |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
06105 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
106 |
Number Of Services |
916 |
Number Of Medicare Beneficiaries |
369 |
Total Submitted Charge Amount |
661445 |
Total Medicare Allowed Amount |
210399.12 |
Total Medicare Payment Amount |
159709.43 |
Total Medicare Standardized Payment Amount |
150027.57 |
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 |
106 |
Number Of Medical Services |
916 |
Number Of Medicare Beneficiaries With Medical Services |
369 |
Total Medical Submitted Charge Amount |
661445 |
Total Medical Medicare Allowed Amount |
210399.12 |
Total Medical Medicare Payment Amount |
159709.43 |
Total Medical Medicare Standardized Payment Amount |
150027.57 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
278 |
Number Of Black or African American Beneficiaries |
60 |
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 |
254 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.7233 |