National Provider Identifier [NPI]: |
1720209885 |
Last Name Of The Provider |
GEORGE |
First Name Of The Provider |
JOJY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11155 DUNN RD # PB1 |
Street Address 2 Of The Provider |
SUITE 108N |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631366150 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
183 |
Number Of Medicare Beneficiaries |
79 |
Total Submitted Charge Amount |
144792 |
Total Medicare Allowed Amount |
41129.27 |
Total Medicare Payment Amount |
32151.52 |
Total Medicare Standardized Payment Amount |
32661.76 |
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 |
50 |
Number Of Medical Services |
183 |
Number Of Medicare Beneficiaries With Medical Services |
79 |
Total Medical Submitted Charge Amount |
144792 |
Total Medical Medicare Allowed Amount |
41129.27 |
Total Medical Medicare Payment Amount |
32151.52 |
Total Medical Medicare Standardized Payment Amount |
32661.76 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
48 |
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 |
57 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.054 |