National Provider Identifier [NPI]: |
1790725711 |
Last Name Of The Provider |
HAMMONS |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
27015 JESS MORGAN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROLAND |
Zip Code Of The Provider |
721359016 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
564 |
Number Of Medicare Beneficiaries |
396 |
Total Submitted Charge Amount |
327052 |
Total Medicare Allowed Amount |
63188.17 |
Total Medicare Payment Amount |
48039.73 |
Total Medicare Standardized Payment Amount |
50974.65 |
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 |
564 |
Number Of Medicare Beneficiaries With Medical Services |
396 |
Total Medical Submitted Charge Amount |
327052 |
Total Medical Medicare Allowed Amount |
63188.17 |
Total Medical Medicare Payment Amount |
48039.73 |
Total Medical Medicare Standardized Payment Amount |
50974.65 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
290 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.696 |