National Provider Identifier [NPI]: |
1568499531 |
Last Name Of The Provider |
HARDY |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2550 FLOWOOD DR STE 300 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLOWOOD |
Zip Code Of The Provider |
392329306 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
715 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
40938 |
Total Medicare Allowed Amount |
26889.52 |
Total Medicare Payment Amount |
16698.21 |
Total Medicare Standardized Payment Amount |
18322.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
333 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
6969 |
Total Drug Medicare AllowedAmount |
4025.18 |
Total Drug Medicare PaymentAmount |
3119.7 |
Total Drug Medicare Standardized Payment Amount |
3119.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
382 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
33969 |
Total Medical Medicare Allowed Amount |
22864.34 |
Total Medical Medicare Payment Amount |
13578.51 |
Total Medical Medicare Standardized Payment Amount |
15202.67 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
119 |
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1122 |