National Provider Identifier [NPI]: |
1043259138 |
Last Name Of The Provider |
ALVES |
First Name Of The Provider |
JEAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 BOWDOIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DORCHESTER |
Zip Code Of The Provider |
021221817 |
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 |
5 |
Number Of Services |
459 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
53922 |
Total Medicare Allowed Amount |
33439.54 |
Total Medicare Payment Amount |
20731.27 |
Total Medicare Standardized Payment Amount |
19908.81 |
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 |
5 |
Number Of Medical Services |
459 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
53922 |
Total Medical Medicare Allowed Amount |
33439.54 |
Total Medical Medicare Payment Amount |
20731.27 |
Total Medical Medicare Standardized Payment Amount |
19908.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
50 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
56 |
Number Of Beneficiaries With Medicare Only Entitlement |
48 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
11 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
11 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
18 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.01 |