National Provider Identifier [NPI]: |
1124017546 |
Last Name Of The Provider |
GARNER |
First Name Of The Provider |
SHUNDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
953 NORTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392022615 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1580 |
Number Of Medicare Beneficiaries |
715 |
Total Submitted Charge Amount |
334228 |
Total Medicare Allowed Amount |
99046.34 |
Total Medicare Payment Amount |
69232.15 |
Total Medicare Standardized Payment Amount |
73862.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
252 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
6120 |
Total Drug Medicare AllowedAmount |
43.47 |
Total Drug Medicare PaymentAmount |
33.97 |
Total Drug Medicare Standardized Payment Amount |
33.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1328 |
Number Of Medicare Beneficiaries With Medical Services |
715 |
Total Medical Submitted Charge Amount |
328108 |
Total Medical Medicare Allowed Amount |
99002.87 |
Total Medical Medicare Payment Amount |
69198.18 |
Total Medical Medicare Standardized Payment Amount |
73828.09 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
288 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
427 |
Number Of Male Beneficiaries |
288 |
Number Of Non Hispanic White Beneficiaries |
435 |
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 |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
428 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4196 |