National Provider Identifier [NPI]: |
1437192465 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4085 CLOUD SPRINGS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
RINGGOLD |
Zip Code Of The Provider |
307368411 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
7789 |
Number Of Medicare Beneficiaries |
312 |
Total Submitted Charge Amount |
596536 |
Total Medicare Allowed Amount |
335263.28 |
Total Medicare Payment Amount |
249658.49 |
Total Medicare Standardized Payment Amount |
247877.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
2930 |
Number Of Medicare Beneficiaries With Drug Services |
122 |
Total Drug Submitted ChargeAmount |
159851 |
Total Drug Medicare AllowedAmount |
132183.59 |
Total Drug Medicare PaymentAmount |
103178.47 |
Total Drug Medicare Standardized Payment Amount |
103178.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
4859 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
436685 |
Total Medical Medicare Allowed Amount |
203079.69 |
Total Medical Medicare Payment Amount |
146480.02 |
Total Medical Medicare Standardized Payment Amount |
144699.34 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
295 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0468 |