National Provider Identifier [NPI]: |
1639137359 |
Last Name Of The Provider |
GRAYBILL |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3190 N SWAN RD |
Street Address 2 Of The Provider |
CAMP LOWELL MEDICAL SPECIALISTS |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
85712 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
186 |
Number Of Services |
8016 |
Number Of Medicare Beneficiaries |
561 |
Total Submitted Charge Amount |
486246 |
Total Medicare Allowed Amount |
246734.93 |
Total Medicare Payment Amount |
206053.24 |
Total Medicare Standardized Payment Amount |
208580.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
1487 |
Number Of Medicare Beneficiaries With Drug Services |
200 |
Total Drug Submitted ChargeAmount |
33682 |
Total Drug Medicare AllowedAmount |
20560.01 |
Total Drug Medicare PaymentAmount |
19971.78 |
Total Drug Medicare Standardized Payment Amount |
19971.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
175 |
Number Of Medical Services |
6529 |
Number Of Medicare Beneficiaries With Medical Services |
561 |
Total Medical Submitted Charge Amount |
452564 |
Total Medical Medicare Allowed Amount |
226174.92 |
Total Medical Medicare Payment Amount |
186081.46 |
Total Medical Medicare Standardized Payment Amount |
188608.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
301 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
522 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
539 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.7961 |