National Provider Identifier [NPI]: |
1508848565 |
Last Name Of The Provider |
UDOFF |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 PARKWAY DRIVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
30312 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
182 |
Number Of Services |
4003 |
Number Of Medicare Beneficiaries |
2403 |
Total Submitted Charge Amount |
413958 |
Total Medicare Allowed Amount |
105119.38 |
Total Medicare Payment Amount |
82671.46 |
Total Medicare Standardized Payment Amount |
83528 |
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 |
182 |
Number Of Medical Services |
4003 |
Number Of Medicare Beneficiaries With Medical Services |
2403 |
Total Medical Submitted Charge Amount |
413958 |
Total Medical Medicare Allowed Amount |
105119.38 |
Total Medical Medicare Payment Amount |
82671.46 |
Total Medical Medicare Standardized Payment Amount |
83528 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
638 |
Number Of Beneficiaries Age 65 to 74 |
849 |
Number Of Beneficiaries Age 75 to 84 |
626 |
Number Of Beneficiaries Age Greater 84 |
290 |
Number Of Female Beneficiaries |
1575 |
Number Of Male Beneficiaries |
828 |
Number Of Non Hispanic White Beneficiaries |
1294 |
Number Of Black or African American Beneficiaries |
1037 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1573 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
830 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9163 |