National Provider Identifier [NPI]: |
1396755153 |
Last Name Of The Provider |
TRELA |
First Name Of The Provider |
VALORIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MS RNCS |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 NORTH STREET |
Street Address 2 Of The Provider |
DEPT OF PSYCHIATRY PCOT |
City Of The Provider |
PITTSFIELD |
Zip Code Of The Provider |
01201 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Certified Clinical Nurse Specialist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
540 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
74055.88 |
Total Medicare Allowed Amount |
40326.57 |
Total Medicare Payment Amount |
29957.11 |
Total Medicare Standardized Payment Amount |
35251.8 |
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 |
13 |
Number Of Medical Services |
540 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
74055.88 |
Total Medical Medicare Allowed Amount |
40326.57 |
Total Medical Medicare Payment Amount |
29957.11 |
Total Medical Medicare Standardized Payment Amount |
35251.8 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
39 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
55 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
69 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9731 |