National Provider Identifier [NPI]: |
1174576193 |
Last Name Of The Provider |
GARRAHAN |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
215 TOLL GATE RD |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
WARWICK |
Zip Code Of The Provider |
028864458 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
279 |
Number Of Medicare Beneficiaries |
63 |
Total Submitted Charge Amount |
28582 |
Total Medicare Allowed Amount |
10632.82 |
Total Medicare Payment Amount |
7147.73 |
Total Medicare Standardized Payment Amount |
6458.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2845 |
Total Drug Medicare AllowedAmount |
460.9 |
Total Drug Medicare PaymentAmount |
315.19 |
Total Drug Medicare Standardized Payment Amount |
315.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
195 |
Number Of Medicare Beneficiaries With Medical Services |
63 |
Total Medical Submitted Charge Amount |
25737 |
Total Medical Medicare Allowed Amount |
10171.92 |
Total Medical Medicare Payment Amount |
6832.54 |
Total Medical Medicare Standardized Payment Amount |
6143.11 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
25 |
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 |
48 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
25 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0159 |