National Provider Identifier [NPI]: |
1972838985 |
Last Name Of The Provider |
FAY |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
174 PLEASANT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATTLEBORO |
Zip Code Of The Provider |
027032441 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
577 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
105635 |
Total Medicare Allowed Amount |
72029.32 |
Total Medicare Payment Amount |
46947.91 |
Total Medicare Standardized Payment Amount |
45267.94 |
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 |
18 |
Number Of Medical Services |
577 |
Number Of Medicare Beneficiaries With Medical Services |
500 |
Total Medical Submitted Charge Amount |
105635 |
Total Medical Medicare Allowed Amount |
72029.32 |
Total Medical Medicare Payment Amount |
46947.91 |
Total Medical Medicare Standardized Payment Amount |
45267.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
482 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0727 |