National Provider Identifier [NPI]: |
1225250640 |
Last Name Of The Provider |
JAMES |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16356 COUNTY ROAD 41 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ADDISON |
Zip Code Of The Provider |
355402416 |
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 |
86 |
Number Of Services |
10749 |
Number Of Medicare Beneficiaries |
537 |
Total Submitted Charge Amount |
314234 |
Total Medicare Allowed Amount |
211787.99 |
Total Medicare Payment Amount |
141017.6 |
Total Medicare Standardized Payment Amount |
155865.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
5621 |
Number Of Medicare Beneficiaries With Drug Services |
376 |
Total Drug Submitted ChargeAmount |
48361 |
Total Drug Medicare AllowedAmount |
8253.57 |
Total Drug Medicare PaymentAmount |
7019.49 |
Total Drug Medicare Standardized Payment Amount |
7019.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
5128 |
Number Of Medicare Beneficiaries With Medical Services |
537 |
Total Medical Submitted Charge Amount |
265873 |
Total Medical Medicare Allowed Amount |
203534.42 |
Total Medical Medicare Payment Amount |
133998.11 |
Total Medical Medicare Standardized Payment Amount |
148846.37 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
252 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
390 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9611 |