National Provider Identifier [NPI]: |
1245212208 |
Last Name Of The Provider |
HENDRIX |
First Name Of The Provider |
VERNON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 PARKWAY DR NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303121212 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
169 |
Number Of Services |
2463 |
Number Of Medicare Beneficiaries |
1321 |
Total Submitted Charge Amount |
374134.25 |
Total Medicare Allowed Amount |
86450.4 |
Total Medicare Payment Amount |
65744.15 |
Total Medicare Standardized Payment Amount |
66697 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
405 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1471.25 |
Total Drug Medicare AllowedAmount |
280.03 |
Total Drug Medicare PaymentAmount |
211.22 |
Total Drug Medicare Standardized Payment Amount |
211.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
166 |
Number Of Medical Services |
2058 |
Number Of Medicare Beneficiaries With Medical Services |
1321 |
Total Medical Submitted Charge Amount |
372663 |
Total Medical Medicare Allowed Amount |
86170.37 |
Total Medical Medicare Payment Amount |
65532.93 |
Total Medical Medicare Standardized Payment Amount |
66485.78 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
363 |
Number Of Beneficiaries Age 65 to 74 |
462 |
Number Of Beneficiaries Age 75 to 84 |
321 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
794 |
Number Of Male Beneficiaries |
527 |
Number Of Non Hispanic White Beneficiaries |
630 |
Number Of Black or African American Beneficiaries |
638 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
794 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
527 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1041 |