National Provider Identifier [NPI]: |
1235186636 |
Last Name Of The Provider |
WINDSOR |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2550 WINDY HILL RD |
Street Address 2 Of The Provider |
STE 215 |
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
30067 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
4041 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
915872.24 |
Total Medicare Allowed Amount |
315532.5 |
Total Medicare Payment Amount |
256055.53 |
Total Medicare Standardized Payment Amount |
254121.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
807 |
Number Of Medicare Beneficiaries With Drug Services |
115 |
Total Drug Submitted ChargeAmount |
8401 |
Total Drug Medicare AllowedAmount |
1532.46 |
Total Drug Medicare PaymentAmount |
1191.06 |
Total Drug Medicare Standardized Payment Amount |
1191.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
3234 |
Number Of Medicare Beneficiaries With Medical Services |
457 |
Total Medical Submitted Charge Amount |
907471.24 |
Total Medical Medicare Allowed Amount |
314000.04 |
Total Medical Medicare Payment Amount |
254864.47 |
Total Medical Medicare Standardized Payment Amount |
252930.04 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
345 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
261 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
424 |
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 |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
302 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
2 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2024 |