National Provider Identifier [NPI]: |
1265699433 |
Last Name Of The Provider |
NOVACK |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1326 EISENHOWER DR BLDG 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314063928 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
8495 |
Number Of Medicare Beneficiaries |
619 |
Total Submitted Charge Amount |
617790.54 |
Total Medicare Allowed Amount |
260179.73 |
Total Medicare Payment Amount |
207807.69 |
Total Medicare Standardized Payment Amount |
217713.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
516 |
Number Of Medicare Beneficiaries With Drug Services |
207 |
Total Drug Submitted ChargeAmount |
15859 |
Total Drug Medicare AllowedAmount |
7381.73 |
Total Drug Medicare PaymentAmount |
7039.29 |
Total Drug Medicare Standardized Payment Amount |
7039.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
94 |
Number Of Medical Services |
7979 |
Number Of Medicare Beneficiaries With Medical Services |
619 |
Total Medical Submitted Charge Amount |
601931.54 |
Total Medical Medicare Allowed Amount |
252798 |
Total Medical Medicare Payment Amount |
200768.4 |
Total Medical Medicare Standardized Payment Amount |
210674.1 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
351 |
Number Of Male Beneficiaries |
268 |
Number Of Non Hispanic White Beneficiaries |
400 |
Number Of Black or African American Beneficiaries |
199 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
500 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.423 |