National Provider Identifier [NPI]: |
1003951724 |
Last Name Of The Provider |
PICKERING |
First Name Of The Provider |
TREVOR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1325 E FORTIFICATION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392022442 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
12255 |
Number Of Medicare Beneficiaries |
1343 |
Total Submitted Charge Amount |
3163380 |
Total Medicare Allowed Amount |
846625.69 |
Total Medicare Payment Amount |
636519.56 |
Total Medicare Standardized Payment Amount |
693703.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
5563 |
Number Of Medicare Beneficiaries With Drug Services |
601 |
Total Drug Submitted ChargeAmount |
119345 |
Total Drug Medicare AllowedAmount |
61252.34 |
Total Drug Medicare PaymentAmount |
47331.66 |
Total Drug Medicare Standardized Payment Amount |
47331.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
6692 |
Number Of Medicare Beneficiaries With Medical Services |
1343 |
Total Medical Submitted Charge Amount |
3044035 |
Total Medical Medicare Allowed Amount |
785373.35 |
Total Medical Medicare Payment Amount |
589187.9 |
Total Medical Medicare Standardized Payment Amount |
646372.25 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
606 |
Number Of Beneficiaries Age 75 to 84 |
443 |
Number Of Beneficiaries Age Greater 84 |
165 |
Number Of Female Beneficiaries |
896 |
Number Of Male Beneficiaries |
447 |
Number Of Non Hispanic White Beneficiaries |
1043 |
Number Of Black or African American Beneficiaries |
289 |
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 |
1117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
226 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0331 |