National Provider Identifier [NPI]: |
1447278106 |
Last Name Of The Provider |
CANNON |
First Name Of The Provider |
STERLING |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2616 WARM SPRINGS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
319045323 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
4906 |
Number Of Medicare Beneficiaries |
1017 |
Total Submitted Charge Amount |
633470.5 |
Total Medicare Allowed Amount |
475242.96 |
Total Medicare Payment Amount |
353823.61 |
Total Medicare Standardized Payment Amount |
341383.83 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
473 |
Number Of Beneficiaries Age 75 to 84 |
332 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
659 |
Number Of Male Beneficiaries |
358 |
Number Of Non Hispanic White Beneficiaries |
810 |
Number Of Black or African American Beneficiaries |
167 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
898 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1095 |