National Provider Identifier [NPI]: |
1821148479 |
Last Name Of The Provider |
RICHARD |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
41 MALL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
018050001 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
286 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
50135.14 |
Total Medicare Allowed Amount |
17996.82 |
Total Medicare Payment Amount |
13479.61 |
Total Medicare Standardized Payment Amount |
15630.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
12 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
686.14 |
Total Drug Medicare AllowedAmount |
368.56 |
Total Drug Medicare PaymentAmount |
361.18 |
Total Drug Medicare Standardized Payment Amount |
361.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
274 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
49449 |
Total Medical Medicare Allowed Amount |
17628.26 |
Total Medical Medicare Payment Amount |
13118.43 |
Total Medical Medicare Standardized Payment Amount |
15269.43 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
54 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0125 |