National Provider Identifier [NPI]: |
1639199631 |
Last Name Of The Provider |
AMURAO |
First Name Of The Provider |
GUILLERMO |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3623 J DEWEY GRAY CIR |
Street Address 2 Of The Provider |
STE 107 |
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309096511 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
3740 |
Number Of Medicare Beneficiaries |
612 |
Total Submitted Charge Amount |
805648.71 |
Total Medicare Allowed Amount |
344818.75 |
Total Medicare Payment Amount |
261142.52 |
Total Medicare Standardized Payment Amount |
275835.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
421 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
19650 |
Total Drug Medicare AllowedAmount |
6814.62 |
Total Drug Medicare PaymentAmount |
6400.02 |
Total Drug Medicare Standardized Payment Amount |
6400.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
3319 |
Number Of Medicare Beneficiaries With Medical Services |
612 |
Total Medical Submitted Charge Amount |
785998.71 |
Total Medical Medicare Allowed Amount |
338004.13 |
Total Medical Medicare Payment Amount |
254742.5 |
Total Medical Medicare Standardized Payment Amount |
269435.93 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
239 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
354 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
440 |
Number Of Black or African American Beneficiaries |
149 |
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 |
445 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
167 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
68 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.3672 |