National Provider Identifier [NPI]: |
1700800984 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
MAIN PAVILION-LEVEL 5 VASCULAR |
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
1717 |
Number Of Medicare Beneficiaries |
783 |
Total Submitted Charge Amount |
2000824 |
Total Medicare Allowed Amount |
138850.06 |
Total Medicare Payment Amount |
105043.55 |
Total Medicare Standardized Payment Amount |
109288.31 |
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 |
99 |
Number Of Medical Services |
1717 |
Number Of Medicare Beneficiaries With Medical Services |
783 |
Total Medical Submitted Charge Amount |
2000824 |
Total Medical Medicare Allowed Amount |
138850.06 |
Total Medical Medicare Payment Amount |
105043.55 |
Total Medical Medicare Standardized Payment Amount |
109288.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
303 |
Number Of Beneficiaries Age 75 to 84 |
252 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
372 |
Number Of Male Beneficiaries |
411 |
Number Of Non Hispanic White Beneficiaries |
754 |
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 |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
575 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8147 |