National Provider Identifier [NPI]: |
1336161942 |
Last Name Of The Provider |
WEIL |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
TUFTS-NEMC |
Street Address 2 Of The Provider |
750 WASHINGTON ST #268 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
02111 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1178 |
Number Of Medicare Beneficiaries |
618 |
Total Submitted Charge Amount |
392775 |
Total Medicare Allowed Amount |
117301.62 |
Total Medicare Payment Amount |
84901.1 |
Total Medicare Standardized Payment Amount |
81290.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
58 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
8003 |
Total Drug Medicare AllowedAmount |
3909.5 |
Total Drug Medicare PaymentAmount |
3285.52 |
Total Drug Medicare Standardized Payment Amount |
3285.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1120 |
Number Of Medicare Beneficiaries With Medical Services |
618 |
Total Medical Submitted Charge Amount |
384772 |
Total Medical Medicare Allowed Amount |
113392.12 |
Total Medical Medicare Payment Amount |
81615.58 |
Total Medical Medicare Standardized Payment Amount |
78005.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
378 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
489 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
429 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
38 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.9568 |