National Provider Identifier [NPI]: |
1396973863 |
Last Name Of The Provider |
BOX |
First Name Of The Provider |
SAMUEL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
118 HOSPITAL STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIPLEY |
Zip Code Of The Provider |
38663 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
101 |
Number Of Services |
11464 |
Number Of Medicare Beneficiaries |
862 |
Total Submitted Charge Amount |
991236.36 |
Total Medicare Allowed Amount |
346486.32 |
Total Medicare Payment Amount |
263712.7 |
Total Medicare Standardized Payment Amount |
286170.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
6741 |
Number Of Medicare Beneficiaries With Drug Services |
525 |
Total Drug Submitted ChargeAmount |
114770.36 |
Total Drug Medicare AllowedAmount |
69267.61 |
Total Drug Medicare PaymentAmount |
53505.45 |
Total Drug Medicare Standardized Payment Amount |
53505.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
4723 |
Number Of Medicare Beneficiaries With Medical Services |
862 |
Total Medical Submitted Charge Amount |
876466 |
Total Medical Medicare Allowed Amount |
277218.71 |
Total Medical Medicare Payment Amount |
210207.25 |
Total Medical Medicare Standardized Payment Amount |
232664.56 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
279 |
Number Of Beneficiaries Age 65 to 74 |
328 |
Number Of Beneficiaries Age 75 to 84 |
193 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
585 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
748 |
Number Of Black or African American Beneficiaries |
102 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
542 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
320 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9476 |