National Provider Identifier [NPI]: |
1801826474 |
Last Name Of The Provider |
KEELER |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5000 W 4TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HATTIESBURG |
Zip Code Of The Provider |
394021000 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
221 |
Number Of Services |
10830 |
Number Of Medicare Beneficiaries |
5451 |
Total Submitted Charge Amount |
1410953 |
Total Medicare Allowed Amount |
320760.6 |
Total Medicare Payment Amount |
235461.84 |
Total Medicare Standardized Payment Amount |
258511.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
2271 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
3395 |
Total Drug Medicare AllowedAmount |
947.37 |
Total Drug Medicare PaymentAmount |
708.25 |
Total Drug Medicare Standardized Payment Amount |
708.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
219 |
Number Of Medical Services |
8559 |
Number Of Medicare Beneficiaries With Medical Services |
5451 |
Total Medical Submitted Charge Amount |
1407558 |
Total Medical Medicare Allowed Amount |
319813.23 |
Total Medical Medicare Payment Amount |
234753.59 |
Total Medical Medicare Standardized Payment Amount |
257803.2 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
1324 |
Number Of Beneficiaries Age 65 to 74 |
1964 |
Number Of Beneficiaries Age 75 to 84 |
1479 |
Number Of Beneficiaries Age Greater 84 |
684 |
Number Of Female Beneficiaries |
3184 |
Number Of Male Beneficiaries |
2267 |
Number Of Non Hispanic White Beneficiaries |
4048 |
Number Of Black or African American Beneficiaries |
1336 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
3234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
2217 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7612 |