National Provider Identifier [NPI]: |
1255652053 |
Last Name Of The Provider |
LI |
First Name Of The Provider |
LING |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
45 MEDICAL CENTER CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
COMMERCE |
Zip Code Of The Provider |
305291085 |
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 |
32 |
Number Of Services |
389 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
42998.82 |
Total Medicare Allowed Amount |
27367.51 |
Total Medicare Payment Amount |
20013.23 |
Total Medicare Standardized Payment Amount |
21264.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
680.89 |
Total Drug Medicare AllowedAmount |
296.97 |
Total Drug Medicare PaymentAmount |
278.13 |
Total Drug Medicare Standardized Payment Amount |
278.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
374 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
42317.93 |
Total Medical Medicare Allowed Amount |
27070.54 |
Total Medical Medicare Payment Amount |
19735.1 |
Total Medical Medicare Standardized Payment Amount |
20986.12 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
26 |
Number Of Non Hispanic White Beneficiaries |
84 |
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 |
49 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2673 |