National Provider Identifier [NPI]: |
1770834582 |
Last Name Of The Provider |
DEAN |
First Name Of The Provider |
MEGHAN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
585 LEBANON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELROSE |
Zip Code Of The Provider |
021763225 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
533 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
203455 |
Total Medicare Allowed Amount |
46145.45 |
Total Medicare Payment Amount |
34643.33 |
Total Medicare Standardized Payment Amount |
40146.91 |
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 |
26 |
Number Of Medical Services |
533 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
203455 |
Total Medical Medicare Allowed Amount |
46145.45 |
Total Medical Medicare Payment Amount |
34643.33 |
Total Medical Medicare Standardized Payment Amount |
40146.91 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
170 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7685 |