National Provider Identifier [NPI]: |
1528014628 |
Last Name Of The Provider |
ROBSON |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1108 ROSS CLARK CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DOTHAN |
Zip Code Of The Provider |
363013022 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
669 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
130816 |
Total Medicare Allowed Amount |
97089.06 |
Total Medicare Payment Amount |
73249.96 |
Total Medicare Standardized Payment Amount |
78534.72 |
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 |
21 |
Number Of Medical Services |
669 |
Number Of Medicare Beneficiaries With Medical Services |
500 |
Total Medical Submitted Charge Amount |
130816 |
Total Medical Medicare Allowed Amount |
97089.06 |
Total Medical Medicare Payment Amount |
73249.96 |
Total Medical Medicare Standardized Payment Amount |
78534.72 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
244 |
Number Of Non Hispanic White Beneficiaries |
337 |
Number Of Black or African American Beneficiaries |
|
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 |
270 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
230 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.2011 |