National Provider Identifier [NPI]: |
1740252170 |
Last Name Of The Provider |
UPSHAW |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 HOSPITAL DR |
Street Address 2 Of The Provider |
BLDG C, STE 200 |
City Of The Provider |
MACON |
Zip Code Of The Provider |
312173899 |
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 |
168 |
Number Of Services |
18860 |
Number Of Medicare Beneficiaries |
725 |
Total Submitted Charge Amount |
658454 |
Total Medicare Allowed Amount |
541875.34 |
Total Medicare Payment Amount |
446826.84 |
Total Medicare Standardized Payment Amount |
467852.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
491 |
Number Of Medicare Beneficiaries With Drug Services |
261 |
Total Drug Submitted ChargeAmount |
15577 |
Total Drug Medicare AllowedAmount |
12763.24 |
Total Drug Medicare PaymentAmount |
12456.95 |
Total Drug Medicare Standardized Payment Amount |
12456.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
150 |
Number Of Medical Services |
18369 |
Number Of Medicare Beneficiaries With Medical Services |
725 |
Total Medical Submitted Charge Amount |
642877 |
Total Medical Medicare Allowed Amount |
529112.1 |
Total Medical Medicare Payment Amount |
434369.89 |
Total Medical Medicare Standardized Payment Amount |
455395.15 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
274 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
358 |
Number Of Male Beneficiaries |
367 |
Number Of Non Hispanic White Beneficiaries |
645 |
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 |
707 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
2 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9847 |