National Provider Identifier [NPI]: |
1932295235 |
Last Name Of The Provider |
TOLAND |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9000 BAILEY COVE RD SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HUNTSVILLE |
Zip Code Of The Provider |
358024002 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1489 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
104354 |
Total Medicare Allowed Amount |
71079.28 |
Total Medicare Payment Amount |
44422 |
Total Medicare Standardized Payment Amount |
50096.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
424 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
9304 |
Total Drug Medicare AllowedAmount |
4012.2 |
Total Drug Medicare PaymentAmount |
3649.18 |
Total Drug Medicare Standardized Payment Amount |
3649.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
1065 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
95050 |
Total Medical Medicare Allowed Amount |
67067.08 |
Total Medical Medicare Payment Amount |
40772.82 |
Total Medical Medicare Standardized Payment Amount |
46446.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
255 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9193 |