National Provider Identifier [NPI]: |
1811197163 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 15TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309120004 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
780 |
Number Of Medicare Beneficiaries |
725 |
Total Submitted Charge Amount |
289922 |
Total Medicare Allowed Amount |
101935.36 |
Total Medicare Payment Amount |
78608.63 |
Total Medicare Standardized Payment Amount |
81300.78 |
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 |
20 |
Number Of Medical Services |
780 |
Number Of Medicare Beneficiaries With Medical Services |
725 |
Total Medical Submitted Charge Amount |
289922 |
Total Medical Medicare Allowed Amount |
101935.36 |
Total Medical Medicare Payment Amount |
78608.63 |
Total Medical Medicare Standardized Payment Amount |
81300.78 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
436 |
Number Of Male Beneficiaries |
289 |
Number Of Non Hispanic White Beneficiaries |
479 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
171 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
492 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
233 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.5013 |