National Provider Identifier [NPI]: |
1346433521 |
Last Name Of The Provider |
ALEXANDER |
First Name Of The Provider |
ANDREA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
804 N WILEY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DONALSONVILLE |
Zip Code Of The Provider |
398451120 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
3496 |
Number Of Medicare Beneficiaries |
612 |
Total Submitted Charge Amount |
312730 |
Total Medicare Allowed Amount |
182557.49 |
Total Medicare Payment Amount |
129600.1 |
Total Medicare Standardized Payment Amount |
135972.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
8375 |
Total Drug Medicare AllowedAmount |
8221.09 |
Total Drug Medicare PaymentAmount |
6380.78 |
Total Drug Medicare Standardized Payment Amount |
6380.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
3446 |
Number Of Medicare Beneficiaries With Medical Services |
612 |
Total Medical Submitted Charge Amount |
304355 |
Total Medical Medicare Allowed Amount |
174336.4 |
Total Medical Medicare Payment Amount |
123219.32 |
Total Medical Medicare Standardized Payment Amount |
129591.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
349 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
553 |
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 |
476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0359 |