National Provider Identifier [NPI]: |
1033196605 |
Last Name Of The Provider |
VEGA |
First Name Of The Provider |
CHADLEY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2124 14TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERIDIAN |
Zip Code Of The Provider |
393014040 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1002 |
Number Of Medicare Beneficiaries |
739 |
Total Submitted Charge Amount |
951575.45 |
Total Medicare Allowed Amount |
132252.83 |
Total Medicare Payment Amount |
100961.23 |
Total Medicare Standardized Payment Amount |
105780.44 |
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 |
28 |
Number Of Medical Services |
1002 |
Number Of Medicare Beneficiaries With Medical Services |
739 |
Total Medical Submitted Charge Amount |
951575.45 |
Total Medical Medicare Allowed Amount |
132252.83 |
Total Medical Medicare Payment Amount |
100961.23 |
Total Medical Medicare Standardized Payment Amount |
105780.44 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
284 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
428 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
582 |
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 |
328 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
411 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4595 |