National Provider Identifier [NPI]: |
1053337436 |
Last Name Of The Provider |
COREY |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1364 CLIFTON RD NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303221059 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1233 |
Number Of Medicare Beneficiaries |
964 |
Total Submitted Charge Amount |
207979 |
Total Medicare Allowed Amount |
77076.49 |
Total Medicare Payment Amount |
57441.24 |
Total Medicare Standardized Payment Amount |
58899.04 |
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 |
45 |
Number Of Medical Services |
1233 |
Number Of Medicare Beneficiaries With Medical Services |
964 |
Total Medical Submitted Charge Amount |
207979 |
Total Medical Medicare Allowed Amount |
77076.49 |
Total Medical Medicare Payment Amount |
57441.24 |
Total Medical Medicare Standardized Payment Amount |
58899.04 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
284 |
Number Of Beneficiaries Age 65 to 74 |
390 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
504 |
Number Of Male Beneficiaries |
460 |
Number Of Non Hispanic White Beneficiaries |
413 |
Number Of Black or African American Beneficiaries |
515 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
590 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
374 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.1181 |