National Provider Identifier [NPI]: |
1245288125 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
909 N 5TH AVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROME |
Zip Code Of The Provider |
301652706 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
4598 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
345551 |
Total Medicare Allowed Amount |
186538.3 |
Total Medicare Payment Amount |
140866.21 |
Total Medicare Standardized Payment Amount |
148448.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
1734 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
55890 |
Total Drug Medicare AllowedAmount |
27476.35 |
Total Drug Medicare PaymentAmount |
22119.93 |
Total Drug Medicare Standardized Payment Amount |
22119.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
2864 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
289661 |
Total Medical Medicare Allowed Amount |
159061.95 |
Total Medical Medicare Payment Amount |
118746.28 |
Total Medical Medicare Standardized Payment Amount |
126328.74 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
231 |
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 |
213 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9349 |