National Provider Identifier [NPI]: |
1548238389 |
Last Name Of The Provider |
HENDRICK |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
403 W HIGHLAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
INVERNESS |
Zip Code Of The Provider |
344524717 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2569 |
Number Of Medicare Beneficiaries |
232 |
Total Submitted Charge Amount |
366252 |
Total Medicare Allowed Amount |
153492.98 |
Total Medicare Payment Amount |
119245.85 |
Total Medicare Standardized Payment Amount |
118013.48 |
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 |
50 |
Number Of Medical Services |
2569 |
Number Of Medicare Beneficiaries With Medical Services |
232 |
Total Medical Submitted Charge Amount |
366252 |
Total Medical Medicare Allowed Amount |
153492.98 |
Total Medical Medicare Payment Amount |
119245.85 |
Total Medical Medicare Standardized Payment Amount |
118013.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.4587 |