National Provider Identifier [NPI]: |
1427251412 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
821 ST. SEBASTIAN WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309122615 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
3232 |
Number Of Medicare Beneficiaries |
334 |
Total Submitted Charge Amount |
1343085 |
Total Medicare Allowed Amount |
220544.11 |
Total Medicare Payment Amount |
171054.36 |
Total Medicare Standardized Payment Amount |
169261.12 |
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 |
36 |
Number Of Medical Services |
3232 |
Number Of Medicare Beneficiaries With Medical Services |
334 |
Total Medical Submitted Charge Amount |
1343085 |
Total Medical Medicare Allowed Amount |
220544.11 |
Total Medical Medicare Payment Amount |
171054.36 |
Total Medical Medicare Standardized Payment Amount |
169261.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
94 |
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 |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2441 |