National Provider Identifier [NPI]: |
1073834370 |
Last Name Of The Provider |
HAYGOOD |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2400 GORDON SMITH DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOBILE |
Zip Code Of The Provider |
366172319 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
314 |
Number Of Medicare Beneficiaries |
134 |
Total Submitted Charge Amount |
33730 |
Total Medicare Allowed Amount |
27889.2 |
Total Medicare Payment Amount |
21649.43 |
Total Medicare Standardized Payment Amount |
22839.54 |
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 |
5 |
Number Of Medical Services |
314 |
Number Of Medicare Beneficiaries With Medical Services |
134 |
Total Medical Submitted Charge Amount |
33730 |
Total Medical Medicare Allowed Amount |
27889.2 |
Total Medical Medicare Payment Amount |
21649.43 |
Total Medical Medicare Standardized Payment Amount |
22839.54 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
109 |
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 |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
73 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
46 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7293 |