National Provider Identifier [NPI]: |
1629061395 |
Last Name Of The Provider |
BAUTE |
First Name Of The Provider |
ANTONIO |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
40 FOX CHASE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARTERSVILLE |
Zip Code Of The Provider |
301202491 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2786 |
Number Of Medicare Beneficiaries |
936 |
Total Submitted Charge Amount |
352238 |
Total Medicare Allowed Amount |
168257.7 |
Total Medicare Payment Amount |
125253.87 |
Total Medicare Standardized Payment Amount |
127051.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2786 |
Number Of Medicare Beneficiaries With Medical Services |
936 |
Total Medical Submitted Charge Amount |
352238 |
Total Medical Medicare Allowed Amount |
168257.7 |
Total Medical Medicare Payment Amount |
125253.87 |
Total Medical Medicare Standardized Payment Amount |
127051.04 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
404 |
Number Of Beneficiaries Age 75 to 84 |
346 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
488 |
Number Of Male Beneficiaries |
448 |
Number Of Non Hispanic White Beneficiaries |
794 |
Number Of Black or African American Beneficiaries |
77 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
819 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5319 |