National Provider Identifier [NPI]: |
1518945872 |
Last Name Of The Provider |
NAMEN |
First Name Of The Provider |
ANDREW |
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 |
800 PRUDENTIAL DR |
Street Address 2 Of The Provider |
4TH FLOOR MAIN NORTH |
City Of The Provider |
JACKSONVILLE |
Zip Code Of The Provider |
322078202 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1040 |
Number Of Medicare Beneficiaries |
493 |
Total Submitted Charge Amount |
341564.55 |
Total Medicare Allowed Amount |
105024.67 |
Total Medicare Payment Amount |
80422.25 |
Total Medicare Standardized Payment Amount |
84242.91 |
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 |
47 |
Number Of Medical Services |
1040 |
Number Of Medicare Beneficiaries With Medical Services |
493 |
Total Medical Submitted Charge Amount |
341564.55 |
Total Medical Medicare Allowed Amount |
105024.67 |
Total Medical Medicare Payment Amount |
80422.25 |
Total Medical Medicare Standardized Payment Amount |
84242.91 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
176 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
265 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
111 |
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 |
302 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.7762 |