National Provider Identifier [NPI]: |
1699876789 |
Last Name Of The Provider |
FLUKER |
First Name Of The Provider |
SHELLY-ANN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
80 JESSE HILL JR DR SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303033031 |
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 |
17 |
Number Of Services |
480 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
75788 |
Total Medicare Allowed Amount |
38990.99 |
Total Medicare Payment Amount |
27796.86 |
Total Medicare Standardized Payment Amount |
27766.85 |
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 |
17 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
75788 |
Total Medical Medicare Allowed Amount |
38990.99 |
Total Medical Medicare Payment Amount |
27796.86 |
Total Medical Medicare Standardized Payment Amount |
27766.85 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
236 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5978 |