National Provider Identifier [NPI]: |
1326039538 |
Last Name Of The Provider |
GRASS |
First Name Of The Provider |
GERALD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8333 N DAVIS HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
PENSACOLA |
Zip Code Of The Provider |
325146050 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
988 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
203506.57 |
Total Medicare Allowed Amount |
92715.77 |
Total Medicare Payment Amount |
64867.68 |
Total Medicare Standardized Payment Amount |
62291.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
40 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
64 |
Total Drug Medicare AllowedAmount |
29.67 |
Total Drug Medicare PaymentAmount |
22.95 |
Total Drug Medicare Standardized Payment Amount |
22.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
948 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
203442.57 |
Total Medical Medicare Allowed Amount |
92686.1 |
Total Medical Medicare Payment Amount |
64844.73 |
Total Medical Medicare Standardized Payment Amount |
62268.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
242 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4647 |