National Provider Identifier [NPI]: |
1134193196 |
Last Name Of The Provider |
CHILDERS |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
928 NW 57TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326054482 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
4474 |
Number Of Medicare Beneficiaries |
1013 |
Total Submitted Charge Amount |
321173 |
Total Medicare Allowed Amount |
245608.69 |
Total Medicare Payment Amount |
167317.74 |
Total Medicare Standardized Payment Amount |
164862.35 |
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 |
24 |
Number Of Medical Services |
4474 |
Number Of Medicare Beneficiaries With Medical Services |
1013 |
Total Medical Submitted Charge Amount |
321173 |
Total Medical Medicare Allowed Amount |
245608.69 |
Total Medical Medicare Payment Amount |
167317.74 |
Total Medical Medicare Standardized Payment Amount |
164862.35 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
386 |
Number Of Beneficiaries Age 75 to 84 |
394 |
Number Of Beneficiaries Age Greater 84 |
219 |
Number Of Female Beneficiaries |
437 |
Number Of Male Beneficiaries |
576 |
Number Of Non Hispanic White Beneficiaries |
974 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
998 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9566 |