National Provider Identifier [NPI]: |
1184694069 |
Last Name Of The Provider |
HUDSON |
First Name Of The Provider |
JOY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12230 ASHEVILLE HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
INMAN |
Zip Code Of The Provider |
293491845 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
1294 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
177298 |
Total Medicare Allowed Amount |
65910.83 |
Total Medicare Payment Amount |
48046.41 |
Total Medicare Standardized Payment Amount |
52022 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
114 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
6126 |
Total Drug Medicare AllowedAmount |
2093.47 |
Total Drug Medicare PaymentAmount |
1933.4 |
Total Drug Medicare Standardized Payment Amount |
1933.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1180 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
171172 |
Total Medical Medicare Allowed Amount |
63817.36 |
Total Medical Medicare Payment Amount |
46113.01 |
Total Medical Medicare Standardized Payment Amount |
50088.6 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
145 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9866 |