National Provider Identifier [NPI]: |
1033129440 |
Last Name Of The Provider |
ODEN |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1850 CHADWICK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392043404 |
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 |
14 |
Number Of Services |
3588 |
Number Of Medicare Beneficiaries |
682 |
Total Submitted Charge Amount |
380872.05 |
Total Medicare Allowed Amount |
260520.27 |
Total Medicare Payment Amount |
202268.73 |
Total Medicare Standardized Payment Amount |
213977.74 |
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 |
14 |
Number Of Medical Services |
3588 |
Number Of Medicare Beneficiaries With Medical Services |
682 |
Total Medical Submitted Charge Amount |
380872.05 |
Total Medical Medicare Allowed Amount |
260520.27 |
Total Medical Medicare Payment Amount |
202268.73 |
Total Medical Medicare Standardized Payment Amount |
213977.74 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
272 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
377 |
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 |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
430 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
3.0254 |