National Provider Identifier [NPI]: |
1447303557 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
DON |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9975 S EASTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891237949 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
118 |
Number Of Services |
2540 |
Number Of Medicare Beneficiaries |
696 |
Total Submitted Charge Amount |
454225.01 |
Total Medicare Allowed Amount |
125735.29 |
Total Medicare Payment Amount |
84457.05 |
Total Medicare Standardized Payment Amount |
82295.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
28 |
Number Of Drug Services |
690 |
Number Of Medicare Beneficiaries With Drug Services |
149 |
Total Drug Submitted ChargeAmount |
58772 |
Total Drug Medicare AllowedAmount |
1125.78 |
Total Drug Medicare PaymentAmount |
805.94 |
Total Drug Medicare Standardized Payment Amount |
805.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
1850 |
Number Of Medicare Beneficiaries With Medical Services |
696 |
Total Medical Submitted Charge Amount |
395453.01 |
Total Medical Medicare Allowed Amount |
124609.51 |
Total Medical Medicare Payment Amount |
83651.11 |
Total Medical Medicare Standardized Payment Amount |
81489.73 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
378 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
399 |
Number Of Male Beneficiaries |
297 |
Number Of Non Hispanic White Beneficiaries |
518 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
621 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9732 |