National Provider Identifier [NPI]: |
1275535551 |
Last Name Of The Provider |
SCOTT |
First Name Of The Provider |
MICHEAL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
488 WEST BANKHEAD |
Street Address 2 Of The Provider |
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY |
City Of The Provider |
NEW ALBANY |
Zip Code Of The Provider |
38652 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
2720 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
239557 |
Total Medicare Allowed Amount |
122910.31 |
Total Medicare Payment Amount |
87109.62 |
Total Medicare Standardized Payment Amount |
96031.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
563 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
6910 |
Total Drug Medicare AllowedAmount |
4607.37 |
Total Drug Medicare PaymentAmount |
3967.46 |
Total Drug Medicare Standardized Payment Amount |
3967.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
86 |
Number Of Medical Services |
2157 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
232647 |
Total Medical Medicare Allowed Amount |
118302.94 |
Total Medical Medicare Payment Amount |
83142.16 |
Total Medical Medicare Standardized Payment Amount |
92064.35 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
371 |
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 |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2722 |