National Provider Identifier [NPI]: |
1972554459 |
Last Name Of The Provider |
GREGG |
First Name Of The Provider |
XYLINA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3838 S 700 E |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841061466 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
125 |
Number Of Services |
40675 |
Number Of Medicare Beneficiaries |
403 |
Total Submitted Charge Amount |
3844809.5 |
Total Medicare Allowed Amount |
1022137.25 |
Total Medicare Payment Amount |
799530.73 |
Total Medicare Standardized Payment Amount |
807798.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
45 |
Number Of Drug Services |
36022 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
3102328.5 |
Total Drug Medicare AllowedAmount |
759216.29 |
Total Drug Medicare PaymentAmount |
593809.71 |
Total Drug Medicare Standardized Payment Amount |
593809.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
4653 |
Number Of Medicare Beneficiaries With Medical Services |
403 |
Total Medical Submitted Charge Amount |
742481 |
Total Medical Medicare Allowed Amount |
262920.96 |
Total Medical Medicare Payment Amount |
205721.02 |
Total Medical Medicare Standardized Payment Amount |
213989.23 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
277 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
363 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
41 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5687 |