National Provider Identifier [NPI]: |
1891863155 |
Last Name Of The Provider |
HALLER |
First Name Of The Provider |
ALLISON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
782 |
Number Of Medicare Beneficiaries |
414 |
Total Submitted Charge Amount |
361861.9 |
Total Medicare Allowed Amount |
64622.28 |
Total Medicare Payment Amount |
49477.56 |
Total Medicare Standardized Payment Amount |
48958.61 |
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 |
52 |
Number Of Medical Services |
782 |
Number Of Medicare Beneficiaries With Medical Services |
414 |
Total Medical Submitted Charge Amount |
361861.9 |
Total Medical Medicare Allowed Amount |
64622.28 |
Total Medical Medicare Payment Amount |
49477.56 |
Total Medical Medicare Standardized Payment Amount |
48958.61 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
29 |
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 |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3878 |