National Provider Identifier [NPI]: |
1881852309 |
Last Name Of The Provider |
PRYOR |
First Name Of The Provider |
BRYANT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 FERRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479043055 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1021 |
Number Of Medicare Beneficiaries |
626 |
Total Submitted Charge Amount |
287671 |
Total Medicare Allowed Amount |
132328.81 |
Total Medicare Payment Amount |
102423.95 |
Total Medicare Standardized Payment Amount |
105426.36 |
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 |
22 |
Number Of Medical Services |
1021 |
Number Of Medicare Beneficiaries With Medical Services |
626 |
Total Medical Submitted Charge Amount |
287671 |
Total Medical Medicare Allowed Amount |
132328.81 |
Total Medical Medicare Payment Amount |
102423.95 |
Total Medical Medicare Standardized Payment Amount |
105426.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
190 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
354 |
Number Of Male Beneficiaries |
272 |
Number Of Non Hispanic White Beneficiaries |
545 |
Number Of Black or African American Beneficiaries |
44 |
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 |
419 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.3618 |