National Provider Identifier [NPI]: |
1508156761 |
Last Name Of The Provider |
LAND |
First Name Of The Provider |
ANDREW |
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 |
619 19TH ST S |
Street Address 2 Of The Provider |
|
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352491900 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
167 |
Number Of Medicare Beneficiaries |
80 |
Total Submitted Charge Amount |
40499 |
Total Medicare Allowed Amount |
14466.34 |
Total Medicare Payment Amount |
11613.25 |
Total Medicare Standardized Payment Amount |
12579.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
1187 |
Total Drug Medicare AllowedAmount |
627.47 |
Total Drug Medicare PaymentAmount |
614.85 |
Total Drug Medicare Standardized Payment Amount |
614.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
152 |
Number Of Medicare Beneficiaries With Medical Services |
80 |
Total Medical Submitted Charge Amount |
39312 |
Total Medical Medicare Allowed Amount |
13838.87 |
Total Medical Medicare Payment Amount |
10998.4 |
Total Medical Medicare Standardized Payment Amount |
11964.25 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
67 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1079 |