National Provider Identifier [NPI]: |
1225321748 |
Last Name Of The Provider |
EDWARDS |
First Name Of The Provider |
MARLISHA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 MEDICAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323084646 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
540 |
Number Of Medicare Beneficiaries |
68 |
Total Submitted Charge Amount |
46726 |
Total Medicare Allowed Amount |
27869.86 |
Total Medicare Payment Amount |
22734.79 |
Total Medicare Standardized Payment Amount |
23080.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
2158 |
Total Drug Medicare AllowedAmount |
1544.96 |
Total Drug Medicare PaymentAmount |
1474.78 |
Total Drug Medicare Standardized Payment Amount |
1474.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
488 |
Number Of Medicare Beneficiaries With Medical Services |
68 |
Total Medical Submitted Charge Amount |
44568 |
Total Medical Medicare Allowed Amount |
26324.9 |
Total Medical Medicare Payment Amount |
21260.01 |
Total Medical Medicare Standardized Payment Amount |
21605.82 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
56 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3813 |