National Provider Identifier [NPI]: |
1881659407 |
Last Name Of The Provider |
LARRISON |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
619 19TH STREET SOUTH |
Street Address 2 Of The Provider |
JT N325 |
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
35233 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
144 |
Number Of Services |
2841 |
Number Of Medicare Beneficiaries |
1685 |
Total Submitted Charge Amount |
397281.94 |
Total Medicare Allowed Amount |
67977.41 |
Total Medicare Payment Amount |
47627.84 |
Total Medicare Standardized Payment Amount |
54640.69 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
652 |
Number Of Beneficiaries Age 65 to 74 |
594 |
Number Of Beneficiaries Age 75 to 84 |
325 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
1001 |
Number Of Male Beneficiaries |
684 |
Number Of Non Hispanic White Beneficiaries |
1127 |
Number Of Black or African American Beneficiaries |
523 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
450 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.9573 |