National Provider Identifier [NPI]: |
1205828134 |
Last Name Of The Provider |
FERIA |
First Name Of The Provider |
ANDRE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
142 OLD MILL ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAGRANGE |
Zip Code Of The Provider |
302416704 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1694 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
556239.21 |
Total Medicare Allowed Amount |
252397.25 |
Total Medicare Payment Amount |
195676.96 |
Total Medicare Standardized Payment Amount |
194462.84 |
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 |
27 |
Number Of Medical Services |
1694 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
556239.21 |
Total Medical Medicare Allowed Amount |
252397.25 |
Total Medical Medicare Payment Amount |
195676.96 |
Total Medical Medicare Standardized Payment Amount |
194462.84 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
240 |
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 |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
216 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
3.5805 |