National Provider Identifier [NPI]: |
1265471122 |
Last Name Of The Provider |
LAYGO |
First Name Of The Provider |
ROEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4451 PAULSEN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAVANNAH |
Zip Code Of The Provider |
314053637 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
97 |
Number Of Services |
5021 |
Number Of Medicare Beneficiaries |
397 |
Total Submitted Charge Amount |
383782 |
Total Medicare Allowed Amount |
166633.2 |
Total Medicare Payment Amount |
127427.5 |
Total Medicare Standardized Payment Amount |
135575.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
212 |
Number Of Medicare Beneficiaries With Drug Services |
151 |
Total Drug Submitted ChargeAmount |
16634 |
Total Drug Medicare AllowedAmount |
10639.89 |
Total Drug Medicare PaymentAmount |
10273.52 |
Total Drug Medicare Standardized Payment Amount |
10273.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
4809 |
Number Of Medicare Beneficiaries With Medical Services |
397 |
Total Medical Submitted Charge Amount |
367148 |
Total Medical Medicare Allowed Amount |
155993.31 |
Total Medical Medicare Payment Amount |
117153.98 |
Total Medical Medicare Standardized Payment Amount |
125301.95 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
130 |
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 |
345 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2154 |