National Provider Identifier [NPI]: |
1972668200 |
Last Name Of The Provider |
RAINWATER |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
150 GENTILLY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARTERSVILLE |
Zip Code Of The Provider |
301208522 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
171 |
Number Of Services |
9794 |
Number Of Medicare Beneficiaries |
535 |
Total Submitted Charge Amount |
477870.5 |
Total Medicare Allowed Amount |
216447.96 |
Total Medicare Payment Amount |
154538.23 |
Total Medicare Standardized Payment Amount |
170632.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
4298 |
Number Of Medicare Beneficiaries With Drug Services |
246 |
Total Drug Submitted ChargeAmount |
30071.5 |
Total Drug Medicare AllowedAmount |
9216.74 |
Total Drug Medicare PaymentAmount |
7233.06 |
Total Drug Medicare Standardized Payment Amount |
7233.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
150 |
Number Of Medical Services |
5496 |
Number Of Medicare Beneficiaries With Medical Services |
535 |
Total Medical Submitted Charge Amount |
447799 |
Total Medical Medicare Allowed Amount |
207231.22 |
Total Medical Medicare Payment Amount |
147305.17 |
Total Medical Medicare Standardized Payment Amount |
163399.1 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
494 |
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 |
410 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.139 |