National Provider Identifier [NPI]: |
1750442166 |
Last Name Of The Provider |
HANLEY |
First Name Of The Provider |
ALAN |
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 |
150 GENTILLY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARTERSVILLE |
Zip Code Of The Provider |
301208522 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
144 |
Number Of Services |
7630 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
329447 |
Total Medicare Allowed Amount |
153381.16 |
Total Medicare Payment Amount |
111507.09 |
Total Medicare Standardized Payment Amount |
122553.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
3775 |
Number Of Medicare Beneficiaries With Drug Services |
181 |
Total Drug Submitted ChargeAmount |
18743 |
Total Drug Medicare AllowedAmount |
4680.82 |
Total Drug Medicare PaymentAmount |
4043.08 |
Total Drug Medicare Standardized Payment Amount |
4043.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
127 |
Number Of Medical Services |
3855 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
310704 |
Total Medical Medicare Allowed Amount |
148700.34 |
Total Medical Medicare Payment Amount |
107464.01 |
Total Medical Medicare Standardized Payment Amount |
118510.67 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
343 |
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 |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1837 |