National Provider Identifier [NPI]: |
1326181710 |
Last Name Of The Provider |
HAMILTON |
First Name Of The Provider |
TARA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
170 GOVERNORS AVE |
Street Address 2 Of The Provider |
DIABETES CLINIC-LAWRENCE MEMORIAL HOSPITAL |
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
021551643 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
895 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
192643.1 |
Total Medicare Allowed Amount |
75280 |
Total Medicare Payment Amount |
54018.78 |
Total Medicare Standardized Payment Amount |
51858.45 |
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 |
6 |
Number Of Medical Services |
895 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
192643.1 |
Total Medical Medicare Allowed Amount |
75280 |
Total Medical Medicare Payment Amount |
54018.78 |
Total Medical Medicare Standardized Payment Amount |
51858.45 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
327 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
446 |
Number Of Black or African American Beneficiaries |
11 |
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 |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2839 |