National Provider Identifier [NPI]: |
1659323111 |
Last Name Of The Provider |
ROGERS |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3B CLEVELAND CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
296072414 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
26799 |
Number Of Medicare Beneficiaries |
2962 |
Total Submitted Charge Amount |
1959559 |
Total Medicare Allowed Amount |
1103366.37 |
Total Medicare Payment Amount |
778898.68 |
Total Medicare Standardized Payment Amount |
832234.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
2350 |
Number Of Medicare Beneficiaries With Drug Services |
516 |
Total Drug Submitted ChargeAmount |
21183 |
Total Drug Medicare AllowedAmount |
4231.55 |
Total Drug Medicare PaymentAmount |
2888.67 |
Total Drug Medicare Standardized Payment Amount |
2888.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
24449 |
Number Of Medicare Beneficiaries With Medical Services |
2962 |
Total Medical Submitted Charge Amount |
1938376 |
Total Medical Medicare Allowed Amount |
1099134.82 |
Total Medical Medicare Payment Amount |
776010.01 |
Total Medical Medicare Standardized Payment Amount |
829346 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
324 |
Number Of Beneficiaries Age 65 to 74 |
1483 |
Number Of Beneficiaries Age 75 to 84 |
879 |
Number Of Beneficiaries Age Greater 84 |
276 |
Number Of Female Beneficiaries |
1502 |
Number Of Male Beneficiaries |
1460 |
Number Of Non Hispanic White Beneficiaries |
2655 |
Number Of Black or African American Beneficiaries |
220 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
39 |
Number Of Beneficiaries With Medicare Only Entitlement |
2579 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
383 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0079 |