National Provider Identifier [NPI]: |
1548243728 |
Last Name Of The Provider |
GAY |
First Name Of The Provider |
JOE |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4230 HOSPITAL DR |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
MARIANNA |
Zip Code Of The Provider |
324461934 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
95 |
Number Of Services |
8920 |
Number Of Medicare Beneficiaries |
1061 |
Total Submitted Charge Amount |
1655381 |
Total Medicare Allowed Amount |
659550.34 |
Total Medicare Payment Amount |
454333.35 |
Total Medicare Standardized Payment Amount |
465807.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
664 |
Number Of Medicare Beneficiaries With Drug Services |
507 |
Total Drug Submitted ChargeAmount |
42991 |
Total Drug Medicare AllowedAmount |
9296.49 |
Total Drug Medicare PaymentAmount |
8452.65 |
Total Drug Medicare Standardized Payment Amount |
8452.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
8256 |
Number Of Medicare Beneficiaries With Medical Services |
1059 |
Total Medical Submitted Charge Amount |
1612390 |
Total Medical Medicare Allowed Amount |
650253.85 |
Total Medical Medicare Payment Amount |
445880.7 |
Total Medical Medicare Standardized Payment Amount |
457355.25 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
473 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
631 |
Number Of Male Beneficiaries |
430 |
Number Of Non Hispanic White Beneficiaries |
877 |
Number Of Black or African American Beneficiaries |
165 |
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 |
854 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3047 |