National Provider Identifier [NPI]: |
1992925937 |
Last Name Of The Provider |
SWIFT |
First Name Of The Provider |
ALLEN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
603 SCENIC CIRCLE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BONIFAY |
Zip Code Of The Provider |
324253060 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
913 |
Number Of Medicare Beneficiaries |
308 |
Total Submitted Charge Amount |
34565.44 |
Total Medicare Allowed Amount |
32835.43 |
Total Medicare Payment Amount |
22895.93 |
Total Medicare Standardized Payment Amount |
24189.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
223 |
Number Of Medicare Beneficiaries With Drug Services |
184 |
Total Drug Submitted ChargeAmount |
9167.94 |
Total Drug Medicare AllowedAmount |
8070.26 |
Total Drug Medicare PaymentAmount |
7038.58 |
Total Drug Medicare Standardized Payment Amount |
7038.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
690 |
Number Of Medicare Beneficiaries With Medical Services |
308 |
Total Medical Submitted Charge Amount |
25397.5 |
Total Medical Medicare Allowed Amount |
24765.17 |
Total Medical Medicare Payment Amount |
15857.35 |
Total Medical Medicare Standardized Payment Amount |
17150.68 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
283 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9731 |