National Provider Identifier [NPI]: |
1285927491 |
Last Name Of The Provider |
REEVES |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 RIVERBEND DR SW |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
ROME |
Zip Code Of The Provider |
301616005 |
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 |
29 |
Number Of Services |
155 |
Number Of Medicare Beneficiaries |
50 |
Total Submitted Charge Amount |
10123 |
Total Medicare Allowed Amount |
6422.86 |
Total Medicare Payment Amount |
4493.94 |
Total Medicare Standardized Payment Amount |
5112.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
55 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
471 |
Total Drug Medicare AllowedAmount |
98.94 |
Total Drug Medicare PaymentAmount |
67.86 |
Total Drug Medicare Standardized Payment Amount |
67.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
100 |
Number Of Medicare Beneficiaries With Medical Services |
50 |
Total Medical Submitted Charge Amount |
9652 |
Total Medical Medicare Allowed Amount |
6323.92 |
Total Medical Medicare Payment Amount |
4426.08 |
Total Medical Medicare Standardized Payment Amount |
5044.5 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
30 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0558 |