National Provider Identifier [NPI]: |
1124094453 |
Last Name Of The Provider |
HARKINS |
First Name Of The Provider |
DENISE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 NORTH STATE ST |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE DIVISION INTERNAL MEDICINE |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164500 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
714 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
114455 |
Total Medicare Allowed Amount |
58245.36 |
Total Medicare Payment Amount |
41846.66 |
Total Medicare Standardized Payment Amount |
45425.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
983 |
Total Drug Medicare AllowedAmount |
444.85 |
Total Drug Medicare PaymentAmount |
434.66 |
Total Drug Medicare Standardized Payment Amount |
434.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
686 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
113472 |
Total Medical Medicare Allowed Amount |
57800.51 |
Total Medical Medicare Payment Amount |
41412 |
Total Medical Medicare Standardized Payment Amount |
44991.01 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
190 |
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 |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8248 |