National Provider Identifier [NPI]: |
1124185699 |
Last Name Of The Provider |
LORENZO |
First Name Of The Provider |
MAYRA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D., PH.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 STANIFORD ST |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142517 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1130 |
Number Of Medicare Beneficiaries |
327 |
Total Submitted Charge Amount |
287994 |
Total Medicare Allowed Amount |
79255.8 |
Total Medicare Payment Amount |
58357.45 |
Total Medicare Standardized Payment Amount |
53279.83 |
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 |
36 |
Number Of Medical Services |
1130 |
Number Of Medicare Beneficiaries With Medical Services |
327 |
Total Medical Submitted Charge Amount |
287994 |
Total Medical Medicare Allowed Amount |
79255.8 |
Total Medical Medicare Payment Amount |
58357.45 |
Total Medical Medicare Standardized Payment Amount |
53279.83 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
291 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0211 |