National Provider Identifier [NPI]: |
1699716837 |
Last Name Of The Provider |
HAYNES |
First Name Of The Provider |
DEMONDES |
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 |
2500 NORTH STATE STREET |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE DIVISION OF PULMONARY |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164643 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1650 |
Number Of Medicare Beneficiaries |
611 |
Total Submitted Charge Amount |
462166 |
Total Medicare Allowed Amount |
186122.38 |
Total Medicare Payment Amount |
142458.44 |
Total Medicare Standardized Payment Amount |
151407.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1256 |
Total Drug Medicare AllowedAmount |
587.2 |
Total Drug Medicare PaymentAmount |
575.44 |
Total Drug Medicare Standardized Payment Amount |
575.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
1630 |
Number Of Medicare Beneficiaries With Medical Services |
611 |
Total Medical Submitted Charge Amount |
460910 |
Total Medical Medicare Allowed Amount |
185535.18 |
Total Medical Medicare Payment Amount |
141883 |
Total Medical Medicare Standardized Payment Amount |
150831.81 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
249 |
Number Of Beneficiaries Age 65 to 74 |
229 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
299 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
298 |
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 |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
333 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.3851 |