National Provider Identifier [NPI]: |
1194926493 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
ADAM |
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 |
1701 SENATE BLVD |
Street Address 2 Of The Provider |
SUITE 1204A |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
184 |
Number Of Services |
4896 |
Number Of Medicare Beneficiaries |
2905 |
Total Submitted Charge Amount |
532985.75 |
Total Medicare Allowed Amount |
136272.44 |
Total Medicare Payment Amount |
101677.78 |
Total Medicare Standardized Payment Amount |
109694.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
948 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
7453.75 |
Total Drug Medicare AllowedAmount |
746.85 |
Total Drug Medicare PaymentAmount |
560.06 |
Total Drug Medicare Standardized Payment Amount |
560.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
181 |
Number Of Medical Services |
3948 |
Number Of Medicare Beneficiaries With Medical Services |
2905 |
Total Medical Submitted Charge Amount |
525532 |
Total Medical Medicare Allowed Amount |
135525.59 |
Total Medical Medicare Payment Amount |
101117.72 |
Total Medical Medicare Standardized Payment Amount |
109134.31 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
647 |
Number Of Beneficiaries Age 65 to 74 |
1021 |
Number Of Beneficiaries Age 75 to 84 |
790 |
Number Of Beneficiaries Age Greater 84 |
447 |
Number Of Female Beneficiaries |
1678 |
Number Of Male Beneficiaries |
1227 |
Number Of Non Hispanic White Beneficiaries |
2738 |
Number Of Black or African American Beneficiaries |
82 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
35 |
Number Of Beneficiaries With Medicare Only Entitlement |
2118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
787 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.481 |