National Provider Identifier [NPI]: |
1518947522 |
Last Name Of The Provider |
PINZON |
First Name Of The Provider |
MARV |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 WATSON BLVD |
Street Address 2 Of The Provider |
ATTN: RADIOLOGY DEPARTMENT |
City Of The Provider |
WARNER ROBINS |
Zip Code Of The Provider |
310933431 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
164 |
Number Of Services |
3169 |
Number Of Medicare Beneficiaries |
1969 |
Total Submitted Charge Amount |
369169 |
Total Medicare Allowed Amount |
83604.4 |
Total Medicare Payment Amount |
63364.45 |
Total Medicare Standardized Payment Amount |
66443.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
164 |
Number Of Medical Services |
3169 |
Number Of Medicare Beneficiaries With Medical Services |
1969 |
Total Medical Submitted Charge Amount |
369169 |
Total Medical Medicare Allowed Amount |
83604.4 |
Total Medical Medicare Payment Amount |
63364.45 |
Total Medical Medicare Standardized Payment Amount |
66443.63 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
362 |
Number Of Beneficiaries Age 65 to 74 |
727 |
Number Of Beneficiaries Age 75 to 84 |
597 |
Number Of Beneficiaries Age Greater 84 |
283 |
Number Of Female Beneficiaries |
1216 |
Number Of Male Beneficiaries |
753 |
Number Of Non Hispanic White Beneficiaries |
1458 |
Number Of Black or African American Beneficiaries |
458 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1523 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
446 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.852 |