National Provider Identifier [NPI]: |
1831257898 |
Last Name Of The Provider |
MALONE |
First Name Of The Provider |
GREGORY |
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 |
4881 SUGAR MAPLE DR |
Street Address 2 Of The Provider |
88TH MEDICAL GROUP/SGHJ, BLDG 830 |
City Of The Provider |
WRIGHT PATTERSON AFB |
Zip Code Of The Provider |
454335529 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
508 |
Number Of Medicare Beneficiaries |
386 |
Total Submitted Charge Amount |
596278 |
Total Medicare Allowed Amount |
62962.53 |
Total Medicare Payment Amount |
48871.66 |
Total Medicare Standardized Payment Amount |
50781.82 |
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 |
92 |
Number Of Medical Services |
508 |
Number Of Medicare Beneficiaries With Medical Services |
386 |
Total Medical Submitted Charge Amount |
596278 |
Total Medical Medicare Allowed Amount |
62962.53 |
Total Medical Medicare Payment Amount |
48871.66 |
Total Medical Medicare Standardized Payment Amount |
50781.82 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
150 |
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 |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3138 |