National Provider Identifier [NPI]: |
1104812387 |
Last Name Of The Provider |
BELL |
First Name Of The Provider |
ANITA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2402 OSLER CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALBANY |
Zip Code Of The Provider |
317070205 |
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 |
138 |
Number Of Services |
9575 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
785693 |
Total Medicare Allowed Amount |
252681.5 |
Total Medicare Payment Amount |
201277.32 |
Total Medicare Standardized Payment Amount |
213835.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
2150 |
Number Of Medicare Beneficiaries With Drug Services |
256 |
Total Drug Submitted ChargeAmount |
103106 |
Total Drug Medicare AllowedAmount |
38910.23 |
Total Drug Medicare PaymentAmount |
33028.35 |
Total Drug Medicare Standardized Payment Amount |
33028.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
126 |
Number Of Medical Services |
7425 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
682587 |
Total Medical Medicare Allowed Amount |
213771.27 |
Total Medical Medicare Payment Amount |
168248.97 |
Total Medical Medicare Standardized Payment Amount |
180807.22 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
241 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
398 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
466 |
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 |
483 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9286 |