National Provider Identifier [NPI]: |
1962499137 |
Last Name Of The Provider |
AMPIAW |
First Name Of The Provider |
EUNICE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
610 19TH STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
319011528 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
139 |
Number Of Services |
2429 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
185786 |
Total Medicare Allowed Amount |
101167.37 |
Total Medicare Payment Amount |
70418.82 |
Total Medicare Standardized Payment Amount |
75610.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
262 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
4243 |
Total Drug Medicare AllowedAmount |
3322.27 |
Total Drug Medicare PaymentAmount |
2713.26 |
Total Drug Medicare Standardized Payment Amount |
2713.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
130 |
Number Of Medical Services |
2167 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
181543 |
Total Medical Medicare Allowed Amount |
97845.1 |
Total Medical Medicare Payment Amount |
67705.56 |
Total Medical Medicare Standardized Payment Amount |
72897.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
201 |
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 |
298 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3551 |