National Provider Identifier [NPI]: |
1083690952 |
Last Name Of The Provider |
HAYES |
First Name Of The Provider |
DORIS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2315 AARON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT CHARLOTTE |
Zip Code Of The Provider |
339525305 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2300 |
Number Of Medicare Beneficiaries |
807 |
Total Submitted Charge Amount |
538642.78 |
Total Medicare Allowed Amount |
259041.74 |
Total Medicare Payment Amount |
201168.78 |
Total Medicare Standardized Payment Amount |
201117.68 |
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 |
24 |
Number Of Medical Services |
2300 |
Number Of Medicare Beneficiaries With Medical Services |
807 |
Total Medical Submitted Charge Amount |
538642.78 |
Total Medical Medicare Allowed Amount |
259041.74 |
Total Medical Medicare Payment Amount |
201168.78 |
Total Medical Medicare Standardized Payment Amount |
201117.68 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
276 |
Number Of Beneficiaries Age 75 to 84 |
282 |
Number Of Beneficiaries Age Greater 84 |
179 |
Number Of Female Beneficiaries |
483 |
Number Of Male Beneficiaries |
324 |
Number Of Non Hispanic White Beneficiaries |
756 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
681 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9506 |