National Provider Identifier [NPI]: |
1316951999 |
Last Name Of The Provider |
CULPEPPER |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11459 JOHNS CREEK PKWY |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
JOHNS CREEK |
Zip Code Of The Provider |
300973515 |
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 |
24 |
Number Of Services |
280 |
Number Of Medicare Beneficiaries |
79 |
Total Submitted Charge Amount |
24862.85 |
Total Medicare Allowed Amount |
18488.96 |
Total Medicare Payment Amount |
13946.89 |
Total Medicare Standardized Payment Amount |
15197.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
663.64 |
Total Drug Medicare AllowedAmount |
564.92 |
Total Drug Medicare PaymentAmount |
551.12 |
Total Drug Medicare Standardized Payment Amount |
551.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
249 |
Number Of Medicare Beneficiaries With Medical Services |
79 |
Total Medical Submitted Charge Amount |
24199.21 |
Total Medical Medicare Allowed Amount |
17924.04 |
Total Medical Medicare Payment Amount |
13395.77 |
Total Medical Medicare Standardized Payment Amount |
14646.41 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
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 |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6859 |