National Provider Identifier [NPI]: |
1821073982 |
Last Name Of The Provider |
CHERRY |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20 SOUTHBRIDGE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLTON |
Zip Code Of The Provider |
015075235 |
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 |
56 |
Number Of Services |
3067 |
Number Of Medicare Beneficiaries |
552 |
Total Submitted Charge Amount |
698424 |
Total Medicare Allowed Amount |
249452.78 |
Total Medicare Payment Amount |
185472.18 |
Total Medicare Standardized Payment Amount |
181399.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
229 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
141690 |
Total Drug Medicare AllowedAmount |
49573.84 |
Total Drug Medicare PaymentAmount |
38516 |
Total Drug Medicare Standardized Payment Amount |
38516 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
2838 |
Number Of Medicare Beneficiaries With Medical Services |
552 |
Total Medical Submitted Charge Amount |
556734 |
Total Medical Medicare Allowed Amount |
199878.94 |
Total Medical Medicare Payment Amount |
146956.18 |
Total Medical Medicare Standardized Payment Amount |
142883.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
440 |
Number Of Non Hispanic White Beneficiaries |
500 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
438 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2799 |