National Provider Identifier [NPI]: |
1275509184 |
Last Name Of The Provider |
CARTER |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4420 LAKE BOONE TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
RALEIGH |
Zip Code Of The Provider |
276077505 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2273 |
Number Of Medicare Beneficiaries |
796 |
Total Submitted Charge Amount |
393032.15 |
Total Medicare Allowed Amount |
89525.81 |
Total Medicare Payment Amount |
69447.75 |
Total Medicare Standardized Payment Amount |
54396.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2273 |
Number Of Medicare Beneficiaries With Medical Services |
796 |
Total Medical Submitted Charge Amount |
393032.15 |
Total Medical Medicare Allowed Amount |
89525.81 |
Total Medical Medicare Payment Amount |
69447.75 |
Total Medical Medicare Standardized Payment Amount |
54396.36 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
388 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
496 |
Number Of Male Beneficiaries |
300 |
Number Of Non Hispanic White Beneficiaries |
642 |
Number Of Black or African American Beneficiaries |
131 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
693 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4002 |