National Provider Identifier [NPI]: |
1982854170 |
Last Name Of The Provider |
KARLSSON |
First Name Of The Provider |
GOTTFRID |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
49 JESSE HILL JR DR SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303033049 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1031 |
Number Of Medicare Beneficiaries |
555 |
Total Submitted Charge Amount |
1008316 |
Total Medicare Allowed Amount |
108598.19 |
Total Medicare Payment Amount |
83794.97 |
Total Medicare Standardized Payment Amount |
86143.09 |
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 |
29 |
Number Of Medical Services |
1031 |
Number Of Medicare Beneficiaries With Medical Services |
555 |
Total Medical Submitted Charge Amount |
1008316 |
Total Medical Medicare Allowed Amount |
108598.19 |
Total Medical Medicare Payment Amount |
83794.97 |
Total Medical Medicare Standardized Payment Amount |
86143.09 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
246 |
Number Of Non Hispanic White Beneficiaries |
410 |
Number Of Black or African American Beneficiaries |
128 |
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 |
357 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9418 |