National Provider Identifier [NPI]: |
1316007800 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
ARTHUR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
777 HEMLOCK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MACON |
Zip Code Of The Provider |
312012102 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
101 |
Number Of Services |
624 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
533307.86 |
Total Medicare Allowed Amount |
90785.04 |
Total Medicare Payment Amount |
69694.48 |
Total Medicare Standardized Payment Amount |
72682.03 |
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 |
101 |
Number Of Medical Services |
624 |
Number Of Medicare Beneficiaries With Medical Services |
486 |
Total Medical Submitted Charge Amount |
533307.86 |
Total Medical Medicare Allowed Amount |
90785.04 |
Total Medical Medicare Payment Amount |
69694.48 |
Total Medical Medicare Standardized Payment Amount |
72682.03 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
131 |
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 |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1776 |