National Provider Identifier [NPI]: |
1871791434 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 N STATE ST |
Street Address 2 Of The Provider |
SUITE 480 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392022001 |
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 |
118 |
Number Of Services |
10118 |
Number Of Medicare Beneficiaries |
776 |
Total Submitted Charge Amount |
524626.4 |
Total Medicare Allowed Amount |
305937.92 |
Total Medicare Payment Amount |
247057.75 |
Total Medicare Standardized Payment Amount |
263579.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
2787 |
Number Of Medicare Beneficiaries With Drug Services |
125 |
Total Drug Submitted ChargeAmount |
27358 |
Total Drug Medicare AllowedAmount |
22633.06 |
Total Drug Medicare PaymentAmount |
18017.37 |
Total Drug Medicare Standardized Payment Amount |
18017.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
7331 |
Number Of Medicare Beneficiaries With Medical Services |
775 |
Total Medical Submitted Charge Amount |
497268.4 |
Total Medical Medicare Allowed Amount |
283304.86 |
Total Medical Medicare Payment Amount |
229040.38 |
Total Medical Medicare Standardized Payment Amount |
245562.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
320 |
Number Of Beneficiaries Age 75 to 84 |
279 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
468 |
Number Of Male Beneficiaries |
308 |
Number Of Non Hispanic White Beneficiaries |
615 |
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 |
677 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3147 |