Medicare Facts for Dr. James J. Upshaw, MD


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

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