National Provider Identifier [NPI]: |
1447298328 |
Last Name Of The Provider |
MAJOR |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6060 N FOUNTAIN PLAZA DR |
Street Address 2 Of The Provider |
STE 270 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857047870 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2266 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
366196 |
Total Medicare Allowed Amount |
142396.45 |
Total Medicare Payment Amount |
102897.95 |
Total Medicare Standardized Payment Amount |
104505.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
1070 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
48755 |
Total Drug Medicare AllowedAmount |
15457.09 |
Total Drug Medicare PaymentAmount |
12414.95 |
Total Drug Medicare Standardized Payment Amount |
12414.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1196 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
317441 |
Total Medical Medicare Allowed Amount |
126939.36 |
Total Medical Medicare Payment Amount |
90483 |
Total Medical Medicare Standardized Payment Amount |
92090.44 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
285 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
288 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9275 |