National Provider Identifier [NPI]: |
1215979257 |
Last Name Of The Provider |
SANDERS |
First Name Of The Provider |
HARVEY |
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 |
305 JONES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WAYNESBORO |
Zip Code Of The Provider |
308301510 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
3786 |
Number Of Medicare Beneficiaries |
524 |
Total Submitted Charge Amount |
109411.27 |
Total Medicare Allowed Amount |
49531.72 |
Total Medicare Payment Amount |
44448.67 |
Total Medicare Standardized Payment Amount |
46021.78 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
208 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
303 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
324 |
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 |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
181 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0342 |