National Provider Identifier [NPI]: |
1942220371 |
Last Name Of The Provider |
PURSELL |
First Name Of The Provider |
SUSAN |
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 |
480 MAPLE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVERS |
Zip Code Of The Provider |
01923 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
3273 |
Number Of Medicare Beneficiaries |
800 |
Total Submitted Charge Amount |
989218 |
Total Medicare Allowed Amount |
271456.5 |
Total Medicare Payment Amount |
204988.59 |
Total Medicare Standardized Payment Amount |
200544.09 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
297 |
Number Of Beneficiaries Age 75 to 84 |
257 |
Number Of Beneficiaries Age Greater 84 |
151 |
Number Of Female Beneficiaries |
579 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
773 |
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 |
614 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3515 |