National Provider Identifier [NPI]: |
1821376740 |
Last Name Of The Provider |
MELAMUD |
First Name Of The Provider |
POLINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
85 SEYMOUR ST |
Street Address 2 Of The Provider |
SUITE 900 |
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
061065501 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
717 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
96466 |
Total Medicare Allowed Amount |
43848.91 |
Total Medicare Payment Amount |
34323.27 |
Total Medicare Standardized Payment Amount |
38137.51 |
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 |
10 |
Number Of Medical Services |
717 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
96466 |
Total Medical Medicare Allowed Amount |
43848.91 |
Total Medical Medicare Payment Amount |
34323.27 |
Total Medical Medicare Standardized Payment Amount |
38137.51 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
6.1106 |