National Provider Identifier [NPI]: |
1790724276 |
Last Name Of The Provider |
SLOAN |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 MEDICAL PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATMORE |
Zip Code Of The Provider |
365023006 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
193 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
105863 |
Total Medicare Allowed Amount |
22087.78 |
Total Medicare Payment Amount |
15635.98 |
Total Medicare Standardized Payment Amount |
16595.86 |
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 |
20 |
Number Of Medical Services |
193 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
105863 |
Total Medical Medicare Allowed Amount |
22087.78 |
Total Medical Medicare Payment Amount |
15635.98 |
Total Medical Medicare Standardized Payment Amount |
16595.86 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
125 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3341 |