National Provider Identifier [NPI]: |
1922176718 |
Last Name Of The Provider |
WATERMAN |
First Name Of The Provider |
ALYSON |
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 |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
SHANDS HOSPITAL, DEPARTMENT OF SURGERY |
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
32608 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
617 |
Number Of Medicare Beneficiaries |
335 |
Total Submitted Charge Amount |
753076.2 |
Total Medicare Allowed Amount |
111933.66 |
Total Medicare Payment Amount |
84814.59 |
Total Medicare Standardized Payment Amount |
81768.85 |
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 |
111 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
335 |
Total Medical Submitted Charge Amount |
753076.2 |
Total Medical Medicare Allowed Amount |
111933.66 |
Total Medical Medicare Payment Amount |
84814.59 |
Total Medical Medicare Standardized Payment Amount |
81768.85 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
166 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
240 |
Number Of Black or African American Beneficiaries |
81 |
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 |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.8811 |