National Provider Identifier [NPI]: |
1245410653 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
THOMAS |
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 |
3320 OLD JEFFERSON RD |
Street Address 2 Of The Provider |
SUITE 200A |
City Of The Provider |
ATHENS |
Zip Code Of The Provider |
306071400 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2201 |
Number Of Medicare Beneficiaries |
673 |
Total Submitted Charge Amount |
361534 |
Total Medicare Allowed Amount |
188464.06 |
Total Medicare Payment Amount |
144860.62 |
Total Medicare Standardized Payment Amount |
150911.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2688 |
Total Drug Medicare AllowedAmount |
2319.85 |
Total Drug Medicare PaymentAmount |
2197.11 |
Total Drug Medicare Standardized Payment Amount |
2197.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
2166 |
Number Of Medicare Beneficiaries With Medical Services |
673 |
Total Medical Submitted Charge Amount |
358846 |
Total Medical Medicare Allowed Amount |
186144.21 |
Total Medical Medicare Payment Amount |
142663.51 |
Total Medical Medicare Standardized Payment Amount |
148714.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
285 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
326 |
Number Of Non Hispanic White Beneficiaries |
564 |
Number Of Black or African American Beneficiaries |
87 |
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 |
469 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1059 |